This guidance is jointly compiled by GPC (England), along with NHS England and NHS Digital, to assist General Practitioners and their staff comprehend the many way that is effective of e-RS and thus help them into the handling of their clients.

This guidance is jointly compiled by GPC (England), along with NHS England and NHS Digital, to assist General Practitioners and their staff comprehend the many way that is effective of e-RS and thus help them into the handling of their clients.

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Initiated in 2015, adhering to a refresh and redesign regarding the old Select and Book system, the NHS e-Referral Service (e-RS) has become being used throughout the nationwide Health provider (NHS) in England. Whenever correctly implemented, e-RS provides benefits that are significant not merely for clients, also for referrers, providers and also for the wider NHS, by delivering option, certainty, safety and dependability.

Along with providing a simplified and completely built-in scheduling solution, e-RS provides a vital possibility to increase the experience that is patient. It offers reassurance into the secure distribution regarding the recommendation information and, more often than not, the ability to book a consultation at enough time of recommendation. It decreases waiting times, weighed against traditional referral methods ( e.g. fax, e-mail or page), and sets the individual more responsible for their care path, offering them more control and freedom into the handling of their own health care at extremely uncertain times in their everyday lives.

This guidance happens to be jointly published by GPC (England), along side NHS England and NHS Digital, to greatly help organisations understand the need for making use of review e-RS because it’s meant to be utilized. It ought to be noted that the old-fashioned part associated with the doctor in decision creating whenever referring clients to medical center (where appropriate), have not changed – simply the mode by which they are doing it. It really is hoped that the guidance supplied here will likely be recognised and implemented by GPs among others utilising the System that is e-Referral to clients, in order that all clients, anywhere these are generally in England, will go through the exact exact same top-quality of recommendations into NHS care.

Dr Nikita Kanani
Acting Director of Main Care
NHS England

Dr Farah Jameel
England Executive Team
GPC England

Dr Stephen C Miller
National Medical Director and Service holder
NHS e-Referral Service (NHS Digital)

1. Introduction

The NHS e-Referral Service (e-RS) can be an electronic referral-support device, built to ensure it is easy for GPs to handle clients whom might need recommendation for onward care. It’s getting used by GP methods in England, with recommendations into both consultant-led out-patient clinics and non-consultant-led solutions, such as for example community, diagnostic, assessment and GPwSI services. The solution aims to:

  • enhance efficiency of recommendations from main to care that is secondary
  • enhance communication that is clinical
  • deliver choice, certainty and control for clients, whom increasingly be prepared to communicate with medical through electronic networks

This guidance is willing to assist General Practitioners and their staff comprehend the many way that is effective of e-RS and therefore help them into the handling of their clients. It’s recognised that referral processes usually differ between specific General techniques, therefore freedom in exactly how e-RS is implemented and applied to a basis that is day-to-day be demonstrated throughout this guidance. This is certainly key to realising some great benefits of the solution.

The NHS e-Referral Service application is undergoing constant technical development and enhancements, centered on user-driven requirements and demands. Included in these are a thorough programme of work to develop Application Programming Interface (API) technology, that may enable current integration with GP medical systems to become a lot more seamless, further improving users’ experiences and allowing them to profit from good quality recommendation management tools from in their GP system that is clinical.

2. Exactly what are the advantages of making use of the NHS e-Referral provider?

The NHS e-Referral provider has a few benefits over other referral methods, including paper and e-mail. It really is:

  • A asset that is national easily offered to all NHS organisations in England
  • an electronic digital, paperless platform for specialists that, unlike email messages, stretches through the point of recommendation in primary care most of the way until the client going to a consultation in a provider organisation
  • sustained by stable and resilient technology, with more than 99.9% system accessibility
  • fully auditable and protected, with referral and scheduling history common to users that are professional in the application (that is – it shows whom did exactly just just what, as soon as)
  • a technique of supporting various recommendation paths, including those leading to the direct scheduling of a scheduled appointment and the ones supplying a short online evaluation of clinical recommendation information
  • a portal that enables clients to choose and book their appointment that is own bookable solutions have already been selected and therefore are available)

3. So how exactly does the NHS e-Referral provider work?

The NHS e-Referral solution is an internet referral and scheduling tool that is consists of two components:

1. a expert application, utilized by referrers (such as for instance GPs) to generate and deliver an electric referral to provider clinicians (such as for example specialists) in additional care, or even community providers.

2. A patient-facing application (called ‘Manage Your Referra’), which allows an individual to book a scheduled appointment online, after the electronic referral happens to be initiated by their referrer in to a service that is bookable. a phone quantity (at neighborhood call rates) is given to clients that are struggling to utilize the on-line scheduling solution.

Expert use of the NHS e-Referral provider presently takes a smartcard, with appropriate roles having been added and authorised by way of a regional nhs enrollment Authority.

An referral that is e-RS be produced into either a bookable solution (in which particular case the client has to book a scheduled appointment ahead of the recommendation may be processed further), or provided for a triage/assessment solution, where in actuality the recommendation info is evaluated first, without a scheduled appointment being pre-booked. Recommendation outcomes vary, dependent on if the referral is into a service that is bookable an evaluation service (see area 6 below on Referral results).

3.1 what’s the distinction between a bookable and an assessment/triage solution?

When described a service that is bookable the in-patient is needed to book a scheduled appointment ahead of the medical recommendation information is visible by the provider. The provider clinician should then view the referral information at the earliest opportunity while making a judgment as to perhaps the client happens to be scheduled to the proper solution, because of the correct urgency, or if the timing associated with visit has to change in light associated with condition being introduced. The provider clinician can select to just accept, re-Direct or replace the date/time associated with visit, using functions in the application that is e-RSsee more information in part 6 below).

In the event that provider clinician seems that their solution just isn’t clinically suitable for the individual and/or there are many more alternative that is suitable of optimising patient care, they could decide to get back the recommendation and advise the referrer properly. This is certainly called a ‘rejection’ but just happens for approximately 2% of recommendations. Where clinically suggested, it must be viewed as an outcome that is positive both in regards to expert training plus in speeding-up client care. If recommendations are refused, the provider should provide clear information as to why they don’t believe that their solution would work for the in-patient and suggest an alternative solution provider or approach to handling the individual. The referrer always gets the choice to resubmit the recommendation with increased information to aid the explanation for referral in to the exact same service, when they believe that is appropriate.

The receiving clinician still reviews the clinical referral information, but before an appointment is booked, and decides on whether to accept the referral if referring to a triage/assessment service. If accepted, the evaluation solution ( perhaps maybe maybe not the GP) must recognize suitable onward service(s) for the contact and patient them to supply a selection (where option rules use) and facilitate the scheduling of a consultation. An assessment service can alternatively provide advice back to the referrer, instead of an visit in addition to converting a triage demand into a scheduled appointment.

3.2 Referral in to a service that is bookable

Listed here four actions should be followed whenever referring as a service that is bookable

1. Check out the Directory of Services (using the integrated search tools) for clinics suited to the patient’s condition.

2. Shortlist one or higher clinics from where the in-patient can decide a consultation.

3. Give you the client with directions about how to pick a hospital and book their visit (printed guidelines are supplied by means of a page, but enhancements that are future enable clients to get electronic guidelines when they desire).

4. Attach clinical recommendation information (such as a recommendation letter or pro-forma) to your electronic recommendation.

When the recommendation up to a bookable solution has been initiated, clients (or other people functioning on their behalf) can book a consultation with among the services detailed. If no appointments can be found at the chosen provider, the individual can decide to try an alternate shortlisted provider, or defer the recommendation request to your medical center or center and wait become contacted with a consultation date (see area 11 below). Hyper Links to videos showing this procedure can be found in the help part of this document – see Section 18 below.

3.3 Referral in to a assessment/triage solution

As described above, along with bookable services, the NHS e-Referral provider supports recommendations into certainly one of three forms of assessment/triage solution. These solutions, that are set-up because of the provider as well as, or in the place of, a straight bookable solution, are specially helpful for complex paths or situations where in fact the client could be scheduled right to test or process, in the place of requiring an outpatient appointment that is initial. In these instances, it will be the additional care clinician who chooses from the most suitable referral path for the individual, as opposed to the referrer (GP).

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