Reviews / 2026
HSSIB interim report: advice and guidance in electronic referral systems
Health Services Safety Investigations Body · work from 2025 · published 2026
What this was
Interim HSSIB investigation, published on 18 August 2026, into patient safety risks in advice-and-guidance services. These services let a GP seek specialist advice instead of, or before, referring a patient. Use has grown as a way of managing waiting lists. HSSIB found examples of good care and examples of delayed or missed diagnosis, including cancer, where local pathways forced advice and guidance or declined referrals despite ongoing concern.
Why it sits in the hub
It is the safety test of a current national access policy. It also shows a class of report this hub does not yet hold in full: HSSIB publishes many investigations. This entry is one of them, included because it is recent and system-wide.
Findings
Finding 1
Where advice and guidance was poorly designed or monitored, it contributed to near misses and harm, including delayed diagnosis of cancer.
Finding 2
Providers could not show that deployment of the electronic referral service had met the required digital clinical safety standards. Safety data from general practice was incomplete.
Recommendations in this hub
The source reports 2 recommendations or essential actions. The notes below are a paraphrase, not the official text.
- 1Awaiting responseNHS England and DHSC
NHS England and the Department of Health and Social Care should rapidly evaluate advice-and-guidance processes. Patient Safety Learning read this as something to finish before further expansion.
- 2Awaiting responseNHS England, DHSC and royal colleges
Commission standard templates for advice-and-guidance requests and responses, with the royal colleges, so the information exchanged is consistent.