Your GP's approach to seeking advice and making a referral to hospital specialists: information for NHS patients
Advice and refer (A&R) is used by GPs to get advice from hospital specialists or refer for an appointment. We now use this pathway for dermatology, neurology and rheumatology. GPs can get advice on things like symptoms and test results in relation to your health and well-being.
Your GP and hospital specialist will work together to decide if you should continue to be cared for by your GP or if you need to be referred to hospital.
Once requested, we aim for the request to be reviewed and responded to by a clinician within 10 working days. The response can range from advice on how to treat the condition in the community or, if hospital care is required, this would be converted to a referral and you could be offered further tests or be booked in for an appointment.
This approach aims to ensure patients receive the appropriate treatment in the most appropriate setting, reducing unnecessary appointments and waiting times.
How does my GP contact the specialist?
Your GP will contact a hospital specialist using the e-Referral Service (e-RS). This pathway is called "advice and guidance" on this system but will allow your GP to use the advice and refer (A&R) pathway. (Locally, we have called the referral process "advice and refer" to help people understand what it's for.)
What happens next?
The hospital specialist will review the information within 10 working days.
If the specialist thinks you will be better cared for by your GP, they will contact your GP with advice on how to manage your care. Your GP will let you know the outcome of this referral and the advice they have received.
If the decision is that you should be seen in hospital, the hospital will contact you to arrange an outpatient or diagnostic appointment.
What if I don’t hear from anyone?
If you haven't heard from anyone after two weeks have passed since your GP consultation, please contact your GP.
If you have been told that you need to be seen in hospital, please be reassured that we have not forgotten about you, and we will be in touch as soon possible. You will have been added to a waiting list.
If you have any queries about a hospital referral, please contact the Booking Centre team.
Is this a new process?
No. GPs have always taken advice from hospital specialists, but we are expanding the use of advice and refer across multiple disease areas.
Why is University Hospitals Birmingham using this approach?
Advice and refer is an important part of your patient journey. It is about equipping your GP with expert knowledge and making sure you are treated by the most appropriate clinician – whether that is your GP or a hospital specialist – as quickly as possible.
Last reviewed: 05 July 2022