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Advice & Guidance Services

Checked: 28-10-2024 by Vicky Ryan Next Review: 27-10-2025

Overview

The following table indicates the current advice and services which are available. This is subject to change so should be checked whenever submitting a request.

Please also see the Advice and Guidance Best Practice page which can support appropriate use of A and G and give secondary care clinicians the information they need to enable them to give their best advice.

Please note a pilot is running to trial allowing secondary care to convert your A&G request into a referral. To allow secondary care to do this, the practice must tick the relevant box on the A&G request, to consent to it being converted, otherwise they can only reply with advice. As of 20.2.23, the following A&G services only are available for conversion to referral:

Dermatology
Rheumatology
Paediatrics - General
Paediatric - Allergy

Details on the process involved can be found here.

Please see the relevant speciality page, via the links in the table, for full details.

Speciality	NBT	UHBW - Bristol	UHBW - Weston	Sirona
Biochemistry advice	Yes	Yes	-	-
Breast	Yes	-	-	-
Cancer Support	Yes	-	-	-
Cardiology	Yes	Yes	Yes	-
Care of the Elderly (Geriatric Medicine)	Urgent Care - Frailty phone number available for advice A&G service also available on eRS	-	-	No but Frailty MDTs
Dermatology	Yes	Yes	-	Yes (for patients who already have a diagnosis)
Diabetic Medicine	Not currently available	-	-	Yes
Dietetics	Yes	-	-	Yes
Endocrinology	Yes	Yes	Yes	-
Ear, Nose And Throat (ENT)	-	Yes	-	-
Fertility	Yes - via Gynae	-	-	-
Gastroenterology	Yes	Yes	Yes (although temporarily switched off)	-
Genetics	-	Via RAS	-	-
Geriatric Medicine (Care of the Elderly)	Yes	-	-	-
Gynaecology	Yes	Yes	Yes	-
Haematology	Yes	Yes	-	-
Hepatology	Yes	-	-
Immunology & Allergy	Yes	-	-	-
Infectious Diseases and microbiology	Yes	Yes	Yes
Learning Disabilities	-	-	-	Yes
Lipids	-	Yes	Urgent advice by phone	-
Max Fax & Dental	-	Yes	-	-
Nephrology	Yes	-	-	-
Neurology	Yes	-	-	-
Neurovascular / Stroke	Yes	-	-	-
Neurosurgery	Yes (via Refer a patient)	-	-	-
Obstetrics	Yes	-	-	-
Oncology	Yes	-	-	-
Ophthalmology	-	Yes	-	-
Orthopaedics	Yes	Yes	Yes	Yes
Pain Management	Yes - limited to appropriateness of a referral	-	-	-
Paediatrics	No	Yes	Yes	No
Physiotherapy	-	-	-	Yes
Podiatry	-	-	-	Yes
Radiology	Yes	Yes	Yes	-
Respiratory Medicine	Yes	Yes	-	Yes
Rheumatology	Yes	Yes	Yes	-
Sarcoma	Yes	-	-	-
Sexual Health	Yes (HIV & LARC)	Yes	-	-
Surgery (General)	No	Yes (but check page for details as some services suspended)	Yes	-
Urology	A& G provided by GP Care
Vascular	Yes	-	-	-

Patients at risk of admission

If you wish to discuss an adult medical patient at risk of admission to hospital, please call the Weekday IUC Professional Line on 0117 2449283 and see the Medical Admissions and Weekday IUC Professional Line page of Remedy.

Clinical responsibilities and medico-legal

Hospital waiting timesPlease see advice from NHSE regarding clinical responsibility and medicolegal aspects of specialist advice (such as advice and guidance and RAS):

Specialist Advice is an umbrella term which encompasses Advice & Guidance (A&G) and Referral Assessment Services/triage (RAS) models. Specialist Advice enables the sharing of relevant clinical information prior to or instead of an outpatient appointment. Specialist Advice between referring and providing clinicians is central to outpatient transformation and elective care recovery. Specialist Advice is expanding rapidly due to advances in digital technology across both the NHS e-Referral service and independent (1).

FAQs:

Updates available via NHS Futures (log in required):

Specialist Advice: Clinical Responsibility and Medicolegal FAQs - Outpatient Recovery and Transformation Platform - FutureNHS Collaboration Platform

Waiting Times for A and G

Please see the Hospital waiting times page.

The waiting time tool for BNSSG GP practices includes a section on A and G waiting times. You will need to download the document and follow the instructions to access the latest information (updated monthly).

Resources

(1) Medicolegal And Clinical Responsibility SA FAQ Executive Summaryv2.4

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.