Homerton – Advice & Refer

In line with national Single Point of Access workstreams, there are some upcoming pathways moving to Advice and Refer.

Advice and referral (A&R) is for GPs and other referrers only. Please refer to the GP Handbook for guidance on how to make an A&R request and for answers to some frequently asked questions. 

Patients should use the contact details in their hospital appointment letter or information leaflet or call the Trust switchboard. 

The following services are already live and using A&R:

• Adult Allergy
• Paediatric Allergy
• Rheumatology
• General Neurology

The following services are switching to A&R from April: 

• General Surgery (Go live on 1st April 2026)
• Plastic Surgery (TBC)
• Urology (TBC)
• Oral Maxillo Facial Surgery (TBC)

Please see the service’s updated Directory of Service on eRS for inclusions and exclusions.

Please contact the appropriate clinical team regarding clinical or patient specific queries.

Frequently Asked A&R Questions

What is changing?

Instead of booking patients directly into outpatient clinics, referrals will be submitted as Advice & Refer requests. Each referral will be clinically reviewed by the specialty team, with one of the following outcomes:

• Advice returned to support ongoing management in primary care
• Referral accepted and booked into the correct clinic
• Referral redirected, with clear clinical advice provided

Why this change is being made?

The Advice & Refer model supports:

• National move to clinical triage of all referrals
• Reduced waiting times to first appointment
• Improved referral quality and fewer inappropriate bookings
• Better communication between primary and secondary care
• Patients being seen in the most appropriate service first time

What do GPs need to do?

• Continue to refer via eRS
• Select the relevant Advice & Refer service
• Include sufficient clinical detail to support safe and timely triage:
  • Presenting complaint and duration
  • Examination findings
  • Investigations completed
  • Treatments tried and response
  • Relevant past medical history

Will this delay care?

No. Patients who need secondary care will be accepted and booked following triage.
Urgent and Urgent Suspected Cancer pathways are unchanged and should continue to be used as normal.

Where can I find more information?

Updated Directory of Services (DoS) entries and for further guidance please see the

• GP Quick Guide which has all inclusions and exclusions
• Homerton’s A&R page
• Service pages on the City & Hackney GP Website