The NHS e-Referral Service (e-RS) is a national digital platform used to refer patients from primary care into elective care services in England. It allows patients to choose their first outpatient hospital or clinic appointment and book it in the GP surgery, online or on the phone. Over several years, the use of e-RS between primary and secondary care in England had maintained a steady position at approximately 50% of such referrals. However, this has more recently increased significantly to close to 100%.
We have used sustainable technical architecture principles to enable e-RS to be more efficient. We have minimised runtime, moved to virtualisation by being hosted on the Cloud, optimised databases to run the system with less energy and enabled a paperless system, especially after integrating e-RS with NHS Login in February 2020, which replaced patient letters with emails.