The Native e-RS Advice & Guidance Upgrade Has Been Paused

Guidance has been landing with general practice and Advice & Refer teams over the past few days confirming that planned upgrades to the native Advice and Guidance module within e-RS have been paused. Priority is shifting instead to upgrades to the Directory of Services, naming conventions, and Single Point of Access (SPoA) functionality, while technical challenges with the A&G module integration are worked through.

For anyone already running Advice & Guidance through an integrated, third-party platform, the practical message in that guidance is a simple one: keep doing what you're doing. Practices and ICBs aren't being asked to change systems, duplicate requests, or move away from existing integrated workflows. Where an integrated or third-party solution is already in use, including where it's aligned with e-RS, that continues exactly as before.

Why this is good news if you're already integrated

It's worth considering why the native module has been paused in the first place. NHS England has cited the technical complexity of integrating Advice & Guidance into the existing system. That's the challenge Cinapsis has already solved, not as a reaction to this announcement, but as the foundation of the platform from the outset.

GPs can already create Advice & Guidance cases either directly within e-RS or within Cinapsis, depending on what works best for their workflow. Cases created in e-RS can be imported into Cinapsis for specialist review, and once a clinician responds, the outcome is written back to e-RS automatically. That means the national record remains complete and up to date without clinicians needing to duplicate work, fully aligning with NHS England's requirement for all Advice & Guidance activity to be visible within e-RS.

We made a similar point before this pause was announced. Expanding Advice & Guidance is undoubtedly a positive step, but making it sustainable requires more than financial incentives. It requires technology that removes friction from the process for everyone involved.

That matters just as much for specialists as it does for GPs. As Advice & Guidance volumes continue to grow, specialists are being asked to manage an increasing clinical workload. Working through e-RS alone can be slow and administratively burdensome, and the now-paused native enhancements were intended to improve that experience. Without those improvements, many teams will continue to face the same inefficient workflows while demand continues to increase.

The decision to pause development of the native module doesn't change the case for integrated platforms. If anything, it strengthens it. Organisations already using Cinapsis can continue delivering efficient, compliant Advice & Guidance with streamlined workflows for both referrers and specialists, while ensuring every case remains visible within e-RS as the national record.

The underlying commitments haven't moved

What's been paused is the upgrade to the native e-RS module, not the underlying ambition behind it. Organisations are still expected to prioritise Advice & Guidance where clinically appropriate across at least ten specialties from April 2026, and to move toward a Single Point of Access with specialist clinical review of A&G requests and referrals (other than urgent suspected cancer) by October 2026, in line with the wider Medium Term Planning Framework commitments. Delivery is simply continuing through existing established methods in the meantime.

That's exactly where Cinapsis already sits. ICBs using Cinapsis aren't waiting on a national upgrade to meet either commitment, because the structured triage, specialist review, and reporting needed for both are already part of how the platform works day to day. 

In dermatology for example, case completion times fell by 25%, with 7 in 10 patient requests resolved without needing a specialist appointment at all.

What this means in practice

If your organisation is already using Cinapsis, this pause changes nothing about your day-to-day workflow, your reporting, or your progress toward the October commitments. If you're currently waiting on a native system upgrade to deliver Advice & Guidance at the scale those commitments require, it may be worth looking at what an already-integrated, already-proven platform can do in the meantime.

You can see what that's looked like in ophthalmology  and dermatology, but Cinapsis works effectively with any speciality.  Alternatively, we’d love you to  get in touch with our team to talk through what it would mean for your own A&G and SPoA commitments.

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