The Advice and Guidance (A&G) Enhanced Service was launched in May 2025 (applicable from 1 April 2025) to support the primary care work involved in seeking pre-referral advice from secondary care. This enhanced service is available on CQRS.

Coding activity

NCL Advice and Guidance EMIS template was created to support Advice and Guidance DES payment capture. NCL ICB encourages the use of this template for all types of advice and guidance. It is accessible from the F12 NCL standard referral letter protocol. Practices are asked to use the SNOMED code "choose and book advice and guidance request”: 820641000000100 to ensure comprehensive capture of all activity. Please note, claims should be made towards each advice and guidance encounter for a particular query (rather than multiple claims for the same episode).

Making claims

Please be reminded to ensure you have a figure uploaded for each month, even if it is a ‘0’ for no activity that month as it prevents any unnecessary reminders and chasing. 

The funding the ICB has been allocated for this provision is an NCL ICB cap from which is drawn down and is not an allocated budget, the ICB will be required in the latter part of the year to take a view on adjusting and reallocating the aggregated cap in line with usage and need, particularly where some practices have not used or underused their cap. Please continue to regularly upload your claims on the 12th of each month to ensure a full picture of your activity is captured.

Advice and guidance considered includes e-RS advice and guidance, consultant connect advice and guidance, telephone or email encounter. Further information can be found on the advice and guidance pages.

NHS England seeking case studies

NHSE and DH are gathering case studies or examples of best practice on any element of utilising A&G and have offered to support writing/formatting the case studies if needed. They are also looking for GPs, who are advocates for A&G willing to do some media in the future. If this is something you are interested in, email nclicb.nclprimarycare@nhs.net