Advice And Guidance (A&G) – What Are The Opportunities For Pharma?
Advice and Guidance (A&G) is fast becoming one of the most important levers in NHS elective recovery.
By allowing GPs to seek specialist advice before making a referral, through platforms such as e-RS or Consultant Connect, it helps patients get quicker answers, reduces unnecessary GP and outpatient appointments and frees up capacity.
Ministers claim more than 100,000 patients have already benefitted from quicker care and A&G is now seen as a frontline tool in tackling waiting lists.
For GPs, A&G provides rapid access to specialist input. But it also brings new workload pressures as every request must be led by a GP, patients must be informed and records updated. For consultants, it requires timely, consistent responses.
For the NHS, success hinges on standardisation across Integrated Care Boards (ICBs) and this is where pharmaceutical companies have a real opportunity to add value by supporting GPs with:
- Education – where focused training and resources can help GPs use A&G effectively, especially in high demand areas such as respiratory medicine, cardiovascular and diabetes.
- Pathway alignment – between primary and secondary care to ensure A&G responses are consistent, evidence based and aligned with best practice.
- Closing the gap – between where the GPs currently refer and where the hospital anticipates they should refer, by helping define what should be managed in General Practice versus secondary care, reducing duplication and uncertainty.
A&G is a cultural shift in how care is delivered. For pharma, it’s a chance to become a trusted partner in reducing GP workload, improving patient outcomes and shaping the advice that drives future care pathways. A&G is here to stay. The time for pharma to engage is now.
Advice And Guidance: A Game Changer For General Practice – And A Strategic Opportunity for Pharma
The NHS is in the middle of a transformation that could quietly reshape the relationship between General Practice, secondary care and industry.
Advice and Guidance (A&G) is the system that allows GPs to seek specialist input before making a referral and it is being expanded at scale, with new funding, stronger expectations and rising use across clinical areas.
What began as a pilot has now become a core plank of elective recovery and the implications for workload, patient experience and system efficiency are huge.
For pharmaceutical companies, A&G represents one of the most overlooked but powerful opportunities to support General Practice.
By helping GPs use A&G effectively, through education, pathway alignment and practical support, industry can position itself as a trusted partner in tackling one of the NHS’s biggest challenges – how to deliver more care outside hospital while reducing waiting lists.
What Is Advice And Guidance And Why Does It Matter?
At its simplest, A&G is a structured way for GPs to get specialist advice without making a formal referral. Through digital platforms, a GP can submit a case summary, ask a question and receive a response from a hospital consultant often within two to five days. The benefits are clear:
- For patients, it means faster answers and, in many cases, treatment that can begin immediately in primary care rather than months later in an outpatient clinic.
- For GPs, it reduces uncertainty and provides access to specialist knowledge that supports clinical decision making.
- For hospitals, it avoids unnecessary referrals, freeing up outpatient capacity for those who genuinely need it.
In 2023/24, around 2.4 million A&G requests were made. NHS England now wants to nearly double this to four million requests in 2025/26, backed by an £80million fund.
Each request will earn practices £20, providing financial recognition for the additional work involved. The government estimates this could keep up to 800,000 patients in primary care each year who would otherwise have been referred. In short, A&G is now central to the NHS’s drive to reduce waiting lists, cut costs and strengthen integrated working between primary and secondary care. A&G Is A Win For Patients And Practices One of the strengths of A&G is its potential to stop patients being bounced between services.
Under traditional pathways, a patient with, for example, respiratory problem might wait months to see a respiratory consultant. With A&G, the GP can get input within days, perhaps advice to request spirometry, tweak medication or try a diagnostic test. The patient benefits from quicker action and avoids the frustration of multiple appointments. Since April 2025, practices have been told they must also ensure patients are informed they are being referred for “pre-referral Advice and Guidance”. This transparency not only builds patient trust but also helps set expectations that care may be managed locally without a hospital visit. The NHS is also defining clear boundaries. A&G is for non-urgent, non-face to face queries, e.g. diagnostic clarification, treatment advice or confirmation of whether referral is appropriate. It is not a substitute for emergency care.
Done well, it ensures the right patient is seen, in the right place, by the right clinician, at the right time – a mantra that underpins NHS elective recovery. Additionally, with earlier GP intervention, A&G also reduces downstream workload while patients wait for outpatient appointments, where they often return the General Practice on many occasions. The Workload Challenge – And The Opportunity For Pharma General Practice remains under huge pressure. Even though A&G helps reduce unnecessary referrals, it can also add to GP workload if poorly implemented. This is where pharmaceutical companies can step in as genuine partners. There are three main opportunities:
1. GPs need education and training
GPs need clarity on when to use A&G, what information to provide and how to act on specialist responses. Pharma can support through high quality educational content, training sessions and case-based learning. For example, in respiratory medicine, the most common A&G requests include queries about asthma management, chronic cough and abnormal chest X-rays. In gynaecology, common themes include irregular bleeding, suspected endometriosis and abnormal ultrasound results. Pharma companies with expertise in these areas are perfectly placed to develop resources that anticipate these questions and support GPs to act confidently at first contact.
2. Pathway alignment will better support GPs
One of the risks of A&G is inconsistency. Different consultants may recommend different investigations, treatments or referral triggers. Industry can help by working with both primary and secondary care to develop clear, evidence-based pathways that are embedded into A&G responses. If these pathways include appropriate use of a company’s medicines, diagnostics or devices, this creates a win-win, as GPs are supported to follow best practice, patients get better outcomes and unnecessary variation is reduced.
3. Close the gap between GPs and consultants
There is often a gap between what GPs believe they can manage and where consultants think their work should begin. A&G shines a light on this gap. Pharma can add value by helping to define and close it, through educational projects, supporting guideline dissemination or providing decision support tools that make it easier for GPs to manage more in primary care. From Incentive To Impact The £20 payment per A&G request is an important lever but incentives alone won’t make the scheme a success. Practices need to feel confident A&G saves them time, avoids duplication and benefits patients. Consultants need to respond promptly and consistently. ICBs need to monitor uptake and ensure local systems are joined up. For pharma, the lesson is clear – A&G is not just another NHS initiative, it is a cultural shift in how care is delivered. By engaging early, companies can help shape what A&G looks like in practice. Will consultants recommend your product as part of patient management? Will they suggest primary care tests that align with your diagnostics? Will they attach guidelines that reference your therapy area? These are the details that will define competitive advantage.
What Practical Steps Should Pharma Be Taking To Optimise Engagement Opportunities?
So what should pharmaceutical companies be doing now?
- Map the landscape to understand which consultants are providing A&G in your therapy area and what advice they typically give.
- Engage with ICBs, as many systems will look to standardise A&G responses across practices and specialties. Be part of the conversation, offering resources that support consistency and best practice.
- Develop educational content, using insights from A&G “top ten” request lists, which are being published in online articles to target the areas where GPs most need help. Tailor content to reduce workload, not add to it.
- Pilot projects, where you work with local practices and trusts to co-design A&G support packages, e.g. combining consultant-led webinars with practical checklists for GPs.
- Measure impact by collecting data on how your interventions reduce repeat consultations, support earlier treatment or improve referral appropriateness. This strengthens your value proposition with the NHS.
Why Does A&G Matter To Sales Teams?
The NHS is betting big on A&G. With elective waits still stubbornly high, Ministers are already pointing to the scheme’s success with 100,000+ more patients in July managed quicker thanks to this funding reform.
Stephen Kinnock MP has also praised GPs for their pivotal role in tackling waits through A&G, calling it an example of how General Practice can help unlock system efficiency. But scaling A&G is not without risks. If GPs feel it simply adds to workload or if patients experience delays when A&G leads to referral anyway, confidence could falter. That’s why pharma has such an important role to play.
By supporting the scheme’s implementation, aligning with pathways, and ensuring education reduces workload rather than adds to it, companies can help make A&G a genuine success story.
A Chance For Pharma To Shape The Future Of Healthcare
Advice and Guidance is a new way of working. It shifts the centre of gravity toward primary care, empowers GPs with specialist input and reduces unnecessary GP and hospital demand. For patients, it promises quicker answers. For the NHS, it offers a route to more efficient use of scarce resources.
For pharmaceutical companies, the opportunity is clear – be part of the solution.
By offering education, aligning with pathways and helping close the gap between primary and secondary care, industry can support GPs to deliver better care with less workload. Those companies that act now will not only build trust with clinicians but also shape the advice that defines future care pathways.
At www.scottmckenzieconsultancy.com, we work directly inside the NHS, supporting provider organisations, commissioners and system leaders to implement real change. We then help pharma, medtech and device companies interpret what’s happening, so they can engage the right stakeholders, align with NHS priorities and get their innovations embedded into care pathways.
With 10 years in pharma and more than 20 years working within the NHS, Scott brings a unique dual perspective, now captured in his upcoming book, launching October 2025, Embedded: How Pharma, MedTech, and Device Companies Can Get Their Products into NHS Pathways and Stay There, which distils everything he’s learned into a practical playbook. Whether you’re launching a new product or trying to unlock stalled adoption, Embedded shows you how to reframe your offer, align with NHS priorities and make change stick.