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e-Referral Service - HL7 V3 API

Create paperless referrals or manage appointment slots in secondary care using the e-Referral Service (e-RS) HL7 V3 API.


Use this API to manage appointment slots for new or existing Patient Administration Systems, using our HL7 V3 API until there is a FHIR version available.

Legal use

This API can only be used where there is a legal basis to do so. Make sure you have a valid use case before you go too far with your development.

You must do this before you can go live (see ‘Onboarding’ below). 

Related APIs

The following APIs are related to this one:

  • e-Referral Service - FHIR API - use this for sending referrals from primary to secondary care (this interaction is deprecated in the e-Referral Service HL7 V3 API) 

API status

This API is stable.

Interactions for sending referrals from primary to secondary care are deprecated and replaced by the e-Referral Service FHIR API.


This API is an HL7 V3 API. It is a mixture of:

  • synchronous interactions, using HL7 V3 SOAP web services
  • asynchronous interactions, using HL7 V3 ebXML messaging

For more details, see HL7 V3.

Network access

You can only access this API via the Health and Social Care Network (HSCN).

For more details, see Network access for APIs.

Security and authorisation


This API is user-restricted, meaning an end user must be present and authenticated to use it.

The end user must be:

  • a healthcare professional
  • strongly authenticated, using either an NHS smartcard or a modern alternative

We support the following security patterns:

  • user-restricted HL7 V3 API, using NHS Identity
  • user-restricted HL7 V3 API, using CIS

For more details see user-restricted APIs.


For some activities, the end user must be authorised to perform that activity.

The API itself does not perform any authorisation checks. Rather, the calling system is expected to perform them. The authorisation rules are specified in our national Role Based Access Control (RBAC) database.

For more details see our national Role Based Access Control (RBAC) database on the registration authorities and smartcards page.


You can test this API using our Path to Live environments.


You must get your software onboarded before it can go live.

As part of onboarding, this API uses the Common Assurance Process (CAP), which is tailored for each NHS service. For more details, contact us.


For a full list of interactions for this API, see the 'Choose and Book' domain in the Spine Message Implementation Manual (MIM).

For details on the general structure of the interactions, see HL7 V3.

Last edited: 12 March 2021 11:05 am