NHS England has retired the Advice and Guidance Enhanced Service and incorporated the funding into Global Sum; this constitutes £1.28 of the total £5.35 increase in 2026/27.
The LMCs advice to colleagues remains unchanged from April 2025, when the Enhanced Service was introduced. There will be some patients whom you may be able to look after appropriately within General Practice if you can obtain additional specialist guidance. In these cases, it remains reasonable to request advice and guidance.
However, from the end of March 2026 there is no item of service payment for this activity.
As before, if the advice and guidance response indicates that the patient would require specialist assessment following direct review, the appropriate course is to refer for that opinion rather than continue management in primary care.