From April 2026, NHS England introduced changes to how GPs refer patients to hospital specialists as part of the recently published Neighbourhood health framework. These changes centre on the Advice and Guidance (A&G) system, which is now a mandatory part of GP care rather than an optional extra.

The aim is to reduce outpatient specialist demand by up to 25% for 10 ‘high volume specialties’ by 2027 and achieve the target of 92% patients starting treatment within 18 weeks of referral.

Advice and Guidance is a system whereby your GP seeks advice from a secondary specialist electronically, referring to a patients’ symptoms, test results, or history for further review of whether an outpatient referral is necessary in each instance.  

Urgent referrals – such as suspected cancer – will not be affected by the change and referrals will continue as before.

GPs are collectively concerned about the proposed contract changes due to the removal of their right to refer and delays in diagnosis and treatment – with 98.9% of BMA’s GP members voting to reject¹.

Whilst these changes may be daunting for healthcare professionals and patients alike, the changes represent an opportunity to reposition private healthcare as a stabilising, navigational, and workforce‑enablement solution to specialist referrals and treatment pathways.

1.  Reshaping the perspective of private healthcare

Utilise communications and benefit design specifics to convey how private healthcare can work in support of the NHS - inclusive of its outpatient diagnostics, consultations, and treatment options.

 Health concerns such as dermatology, MSK, and mental health issues are likely to be impacted by the A&G changes whilst having plentiful of non-NHS support available swiftly, and often through complimentary benefit extras through employee assistant programmes or occupational health, for example, as opposed to private medical insurance. 

2.   Understanding when time is of the essence

 Signposting to a virtual GP service can see patients accessing same-day appointments where they may not be able to see their NHS GP, whereas private medical insurance can bypass considerable NHS waits.  Flexibility in encouraging employees to take these appointments at short notice will assist in longer-term reduction in absences and presenteeism complications through worsening symptoms.

 3.   Offer affordable healthcare options for every budget

 Private healthcare doesn’t deserve its expensive reputation – affordable and flexible options such as health cash plans, of which often include dependents as standard, can help reduce the initial reliance on GP appointments and referrals through everyday care.

Additionally, health screenings offer a variety of affordable options inclusive of gender and/or age specific conditions, for employees to receive expert health guidance on their risk or developing symptoms at an early stage. 

4.   Develop mental health pathways

 Reviewing and enhancing an employee assistance programme (EAP) is a crucial asset to supporting the mental health of your team, with 24/7 advice lines and free counselling services proving a lifeline to thousands of employees.

There are additional mental health support and monitoring tools available as added extras through other benefits, such as general income protection, which may support in managing specific mental health conditions or the stress and anxiety that arises from waiting for diagnosis or treatment. 

5.   Utilise the early intervention support in existing benefits

Occupational health services can act as a bridge between primary care and specialist input, with community-based treatment options readily available and assessments to ensure that early intervention practices are implemented in the first instance. This may often lower the need for later specialist referral, and have employees healthily back to work before escalation.

• Review and strengthen health and wellbeing benefits with a focus on early intervention.

• Prioritise communication so employees understand how to access support quickly.

• Monitor absence trends to identify hotspots and direct targeted resources.

• Position healthcare benefits as a tool for productivity, retention, and resilience.

With NHS access likely to slow under the new A&G system, organisations that proactively invest in faster, more accessible healthcare solutions will protect productivity, reduce absence, and demonstrate a genuine commitment to employee wellbeing.

Let us help you review your current benefits provision and identify practical steps to build a more resilient, healthier workforce.

Get in touch to arrange a consultation or benefits review.

Sources:

1 BMA demands A&G 'pause' or GPs could take collective action from 30 April - Pulse Today