Advice and guidance allows one clinician to seek advice from another. Unlike creating a booking request, where a number of providers can be selected, advice and guidance is a communication between two clinicians: the “requesting” clinician and the provider of a service (the “responding” clinician).

The reasons why a clinician may wish to seek advice and guidance include:

• asking for advice on a treatment plan and/or the ongoing management of a patient
• asking for clarification (or advice) regarding a patient’s test results
• seeking advice on the appropriateness of a referral
• identifying the most clinically appropriate service to refer a patient into

There is no national tariff to provide advice and guidance. It is already covered within the service conditions of the NHS standard contract. 

If the requesting clinician is seeking advice prior to (or instead of) referring a patient, then this has no impact on the commencement of the patient’s clock start. The RTT clock start date is the date that the provider converts the request or receives notice of the referral. For e-RS referrals this is the earliest date that a patient converts (books) their Unique Booking Reference Number or enters the ‘Defer to Provider’ (Appointment Slot Issue) process.