Advice and Refer

Your GP’s Approach to Seeking Advice and Making a Referral to Hospital Specialists: information for NHS patients

What is advice and refer?

Advice and refer (A&R) is used by GPs to get advice from hospital specialists. These specialists may include urologists, respiratory professionals, diabetes specialists and many more. GPs can get advice on things like symptoms and test results in relation to your health and wellbeing. Your GP and hospital specialist will work together to decide if you should continue to be cared for by your GP or if you need to be referred to hospital.

How does my GP contact the specialist?

Your GP can contact a hospital specialist using the NHS’s electronic referral system which is called ERS. You may hear the term ‘advice and guidance’ used during the referral. Locally we have called the referral process to a hospital specialist ‘advice and referral’ to aid understanding of its purpose.

What happens next?

The hospital specialist will review the information within five days. The hospital specialist will contact your GP with advice on how to manage your care or they will decide you should be seen in hospital and offer you an appointment. Your GP will let you know the outcome of this referral and the advice they have received. The hospital will contact you to arrange an appointment if a referral to one of the specialists is needed.

What if I don’t hear from anyone?

If you don’t hear from anyone, after a week has passed since your GP consultation, please contact your GP via Klinik.

If you have been told that you need to be seen in hospital, please be reassured that we have not forgotten about you, and we will be in touch as soon possible. If the hospital has not contacted you within 6 weeks please call the Central Appointments team:

  • For The Royal London Hospital, Mile End Hospital or St Bartholomew's Hospital (non-cardiac patients) call: 020 7767 3200
  • For cardiac patients, contact Barts Heart Centre on: 020 3765 8000
  • For Newham Hospital call: 020 7476 4000 
  • For Whipps Cross Hospital call: 020 8535 6768

Alternatively, you can refer to our website for contact numbers for specific services at

Is this a new process?

No, GPs have always taken advice from hospital specialists, but we are expanding the use of advice and refer across multiple disease areas.

Why is Barts Health doing this?

Advice and refer is an important part of your care journey. It is about equipping your GP with expert knowledge and making sure you are treated by the most appropriate clinician – whether that is your GP or a hospital specialist – as quickly as possible.