The quotas under the Advice and Guidance (A&G) scheme are being imposed to help meet waiting list targets.

The A&G scheme, which was introduced in April 2025, is a digital, two-way communication channel enabling GPs to seek specialist input on patient care without a formal face-to-face referral.

GPs are paid £20 for every extra patient referred to the scheme that is supported by £80m In Government funding.

NHS trusts have been set an interim target of 65% of patients waiting no more than 18 weeks for elective treatment by the end of this month with a further target of 92% by the end of Parliament.

An NHS spokesperson said: ‘While the NHS delivered record numbers of appointments in 2025 and reduced the waiting list to its lowest level in three years, we have much further to go to ensure planned care is easier to access for patients.

‘In addition to transforming how patients can book and manage their care through the NHS App, Advice and Guidance has a major role to play in the coming years to support clinical decision-making and ensure patients are directed to the right specialist care as soon as possible.'

Kat James, managing director of Consultant Connect, which enables the placing of Advice & Guidance requests, said: ‘There's understandable concern when Advice & Guidance is framed as a barrier to referrals, but the reality depends entirely on how it's delivered. When it works well, it gives GPs rapid access to specialist advice so patients get the right care first time.

‘If it's set up well, Advice & Guidance shouldn't feel like a hurdle for patients and GPs. It should mean quicker answers, fewer unnecessary hospital visits, and people getting the care they need without being left waiting longer than they should.'