What is advice and guidance and when might it be used
Advice and guidance allows one clinician to seek advice from another. Unlike creating a booking request, where a number of providers can be selected, advice and guidance is a communication between two clinicians: the “requesting” clinician and the provider of a service (the “responding” clinician).
The reasons why a clinician may wish to seek advice and guidance include:
- asking another clinician or specialist for their advice on a treatment plan and/or the ongoing management of a patient
- asking for clarification (or advice) regarding a patient’s test results
- seeking advice on the appropriateness of a referral for their patient for example, whether to refer, or what the most appropriate alternative care pathway might be
- identifying the most clinically appropriate service to refer a patient into (and how to find that service for example, what clinical term to search on
The requester is able to attach documents to the advice request, which may include diagnostic results, scanned images (for example, ECGs) or previous correspondence related to the patient. They are also able to authorise the responder to convert the request to a referral. The responder is then able to review the request (along with any attachments that may have been added) and, if required, add attachments, such as a proposed treatment plan or links to external documents and websites, before sending a response back to the requestor or converting the request into a referral, where authorisation has been given.
Below is an example image of an advice and guidance conversation.
How a service indicates that it will provide advice to requesting clinicians
When setting a service up on e-RS, a number of factors need to be considered, one of which is whether or not to offer advice and guidance. Providers must also consider any contractual requirements. For example, the Service Conditions of the 2020-2021 Standard Contract state:
6.2.3 the Provider must offer clinical advice and guidance to GPs on potential Referrals through the NHS e-Referral Service, whether this leads to a Referral being made or not.
If providers are going to offer advice through e-RS, they must consider:
Review and response process
- if clinicians are reviewing on line or through a central admin team
- how the responses will get back to the requesting clinician
- how to ensure the service can be provided consistently for example, holiday and sick leave are covered
Agreed turnaround time for response
- how quickly the requesting clinician will receive a response – agree an acceptable timeframe.
Service Definer’s role
- ensuring that the correct clinicians have access to the service and are in the correct workgroup to allow them to easily process the request
If a service is not enabled to offer advice, then, if a requester selects ’advice’ and adds search criteria (for example, Clinical Term, Speciality/Clinic Type or Named Consultant), this service will not be returned, that is only those services that have indicated they will provide advice will be displayed.
Is there a tariff for advice and guidance
There is no national tariff to provide advice and guidance. It is already covered within the service conditions of the NHS standard contract.
In some local health communities, providers and CCGs have agreed a nominal tariff for advice and uidance, to cover some of the administrative costs in setting up such a service. This is anticipated to be recouped by reducing the number of patients who are being referred and managed within a secondary care setting. It is also recognised that this is likely to be far less expensive than setting up administrative referral management centres, which often add no clinical benefit for patients and can be very unpopular with doctors.
Last edited: 29 January 2021 9:48 am