How can Secondary Care deliver Advice & Guidance efficiently and effectively?

Published: 10th April 2024
NHS consultants who answer Advice & Guidance (A&G) queries from both local and out-of-area clinicians told us what makes their A&G provision efficient and effective.
What Makes A Successful Advice & Guidance Line? Consultant Connect

We spoke with 9 NHS consultants* who answer queries from both local and out-of-area clinicians via Telephone and/or Messaging Advice & Guidance (A&G) currently, and asked them what makes their A&G provision efficient and effective:

Queries are easily resolvable

Quite often, consultants can quickly answer questions; for specialties such as respiratory medicine, a diagnosis can frequently come to light through basic history. This means that patients can have their episode of care concluded within primary/community care and receive a management plan simultaneously.

Support for unfamiliar specialties

​On the other hand, many specialties aren’t comprehensively covered in GP specialty training, which is why access to quick and reliable support is so useful. A&G allows consultants to reassure colleagues who may not encounter conditions within these specialties very often.

For example, the complexities of neurology are difficult to cover in a standard 10-minute appointment, and Telephone A&G allows consultants to give relevant, focused, and practical advice, empowering GPs where appropriate.

Other specialties, such as dermatology, by nature, are very visual, which is why Messaging A&G works so well. With good-quality patient photos, a definitive opinion can be given quickly.

Appropriate referrals are ensured

As much as providing A&G avoids unnecessary referrals, it also enables Primary Care clinicians to have their patients seen urgently when necessary. Consultant input can swiftly ensure that a patient is referred to the most relevant clinic, removing delays and repeat referrals.

Ear, nose and throat (ENT) conditions are one of the most common reasons for patients to present in Primary Care, and with a thorough patient management plan, their treatment can often remain in the community. Many questions revolve around when and how to refer, and consultants can provide GPs with the support needed to confidently manage patients in Primary Care if appropriate.

Communication between Primary and Secondary Care is improved

Whether local or out-of-area, consultants can provide management advice, which helps Primary Care assess the urgency of the patient’s condition. This, in turn, strengthens the rapport between all clinicians.

A&G allows consultants to share knowledge, disseminate best practices and provide patient advice booklets, where possible. The feedback from Primary Care is positive and re-establishes the close working relationship.

Support with interpreting results can have big impact

The NHS consultants we spoke with all stated that the most frequent questions they receive relate to imaging and reporting interpretation. Report queries that can be quickly resolved, such as MRIs, radiology, and ultrasounds, that would otherwise result in patients being referred for a specialist appointment.

Reliable response times

For local teams struggling with the capacity to deliver A&G, potentially on certain days or at certain hours, Consultant Connect’s National Consultant Network (NCN) of NHS consultants can be brought on as backup to answer queries, ensuring the service remains reliable. If service levels were to drop, GPs would lose confidence and stop using the service. Ensuring that a backup provision is in place secures the longer-term sustainability of a service.


The NCN is available across the UK and can be switched on in just 24-48 hours to provide short and/or long-term support across 24 specialties. It can then be switched off that quickly when it’s no longer needed. As of April 2024, the most contacted NCN specialties in the last six months were:

  1. Dermatology
  2. Cardiology
  3. Gynaecology
  4. Diabetes and Endocrinology
  5. Haematology
  6. Neurology

* The consultants who provided information specialise in cardiology, neurology, diabetes and endocrine, gastroenterology, ENT, respiratory, and dermatology.

** Data from October 2023 – April 2024.

*** Calls where an outcome was provided.

If you would like to discuss setting up Enhanced Advice & Guidance or switching on the NCN in your area, please email or call 01865 261467.

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