Compliance with the 2026 Mandatory A&G and Single Point of Access (SPoA) Directives

Who should read this

Finance and Service Managers, Clinical Leads, IT Managers, Pathway Coordinators, and Digital Transformation Specialists across NHS Trusts and ICBs.

The 2026 Regulatory and Financial Landscape As of April 2026, NHS policy and the updated GP contract strictly mandate the use of Advice and Guidance (A&G) prior to all planned care referrals. Crucially, this policy dictates that all primary and secondary care requests must be routed through a locally agreed, digitally enabled Single Point of Access (SPoA). Concurrently, the legacy A&G Enhanced Service funding model has been formally retired. Funding is now governed by the Aligned Payment and Incentives (API) variable component of the NHS Payment Scheme, which represents a firm return to activity-based Payment by Results (PbR).

The Operational and Financial Risk This mandatory influx of digital triage places immense pressure on specialist departments. Without a dedicated, structured digital SPoA, departments face two critical risks:

1. Clinical Overwhelm: Ad-hoc systems (such as generic email inboxes, e-RS workarounds, or phone calls) cannot safely manage or filter the mandated high volume of A&G requests, leading to delayed triage and administrative burnout.

2. Revenue Leakage: To claim API funding and Best Practice Tariffs, Trusts must provide an indisputable audit trail of all clinical activity. Unstructured, unrecorded A&G interactions result directly in unbilled activity and a significant loss of departmental revenue.

referapatient is purpose-built to serve as this mandated SPoA, ensuring total compliance with the 2026 directives while safeguarding departmental income:

• Compliant SPoA Triage: referapatient centralises all incoming A&G and referral requests into a single, structured digital front door. Features such as branching algorithms, mandatory data fields, and duplicate detection ensure that only high-quality, actionable referrals reach the specialist team.

• Managing the Influx: To prevent clinical overwhelm, the platform equips specialists with rapid-triage tools, including "canned responses," speech-to-text dictation, and one-click conversion of A&G into physical clinic or MDT appointments.

• Guaranteed API/PbR Capture: The system acts as a chronological, timestamped transactional ledger. Every piece of specialist advice, triage decision, and pathway outcome is permanently recorded and automatically coded. This provides the exact audit trail required by commissioners, guaranteeing that 100% of the department’s A&G activity is captured, billed, and funded under the 2026 Payment by Results framework.

Sources: NHS England, "NHS Payment Scheme" (Effective April 2026). NHS England NHS England, "Single point of access (SPoA)" (August 2024) NHS England and Royal College of General Practitioners (RCGP), "Advice and guidance (A&G)" (2025/26 updates). RCGP Arnold & Porter Legal Advisory, "UK Public Procurement Landscape Transformed" (March 2025) outlining the shift to MAT. Arnold & Porter