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.

NHS England update

In January 2026, NHS England (NHSE) removed the notional cap for Advice and Guidance claims, and all eligible activity can be claimed for with no limit. ICBs will be reimbursed based on actual activity for the 2025-26 financial year. NCL ICB has in turn, removed the notional cap for practice activity (based on weighted list size). This means that practices no longer have a limit on the number of eligible claims per year.  

NHS England seeking case studies

NHSE and the Department of Health and Social Care are gathering case studies or examples of best practice on any element of using 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 and willing to do some media in the future. If this is something you are interested in, email nclicb.nclprimarycare@nhs.net.

Claims for A&G

Practices are urged to upload any outstanding claims to avoid complex end-of-year reconciliation processes. Practices experiencing coding issues, can contact the primary care team on nclicb.nclprimarycare@nhs.net.

• Practices must make manual claims via CQRS National, monthly by the 12th day of each month.
• Practices are advised to ensure they have a figure uploaded for each month, even if it is a ‘0’ for no activity that month to prevent any unnecessary reminders and chasing. 

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

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).

Additional useful guidance has been produced by NCL colleagues to support practices with the coding, recording, and reviewing activity, as well as quality auditing. The document NCL Advice and Guidance coding good practice covers:

• Coding: ensuring you are using the correct codes to record activity
• EMIS resources 
• Reviewing activity: how to see your activity to date accurately
• F12 protocol and template
• Safety netting 
• Further helpful information.

NCL EMIS template

An NCL Advice and Guidance template has been created to support Advice and Guidance DES payment capture, as well as a safety netting feature to support chasing any outstanding replies.

Template is to be used for all types of advice and guidance, accessed via the F12 NCL standard referral letter protocol.

Details of the A&G specification can be found on the NHS England website. 

EMIS resources can be found using the following steps

• Clinical templates and protocols have been published as active via NCL ICB resource publisher. 
• EMIS --> Configuration--> Protocols and Templates --> Shared Folder --> NCL ICB Resource Publisher --> NCL --> Advice and Guidance.

• The searches have been deployed via NHS North Central London CCG enterprise search and reports.

Location of the search

EMIS-->Reporting-->Population Reporting-->NHS North Central London CCG Enterprise Search and Reports-->(NCL ICB) (for all NCL practices)-->(NCL ICB) Advice and Guidance LES