Skip to main content

Referrals and bookings - guidance for specific use cases

Find out which of our national services, APIs and standards to use when building healthcare software that deals with bookings and referrals.

Overview

For some use cases, we provide national services, APIs or standards to make referrals and bookings quicker and easier. This includes:

  • end user applications for healthcare workers and patients
  • API services and standards that allow senders' IT systems to talk directly to receivers' IT systems

An API service is where we provide a physical, callable API for the participating systems to use. An API standard is where we provide an API specification for participating systems to use when integrating directly with one another.

Our services and standards have evolved over time. This means there are different services and standards for different use cases. We are currently working on a single Booking and Referral Standard that will eventually be used for all use cases.

This page explains which national services, APIs or standards to use for specific use cases. For an index of use cases, see the left navigation menu. If your use case isn't included on this page, contact us.


From general practice to hospital or clinic

For referring patients from general practice to a hospital or clinic, use the e-Referral Service (e-RS).

For a summary of the various business processes for e-RS, see Supporting clinical referral pathways - NHS e-referral Service (e-RS).

The following table explains which parts of e-RS to use for specific use cases:

Party Use case(s) Channel Service or standard
Referrer (sender) Service discovery, referral, booking User interface e-RS includes a point-of-care application for referrers - see e-Referral Service for details.
Referrer (sender) Service discovery, referral, booking API e-Referral Service - FHIR API
Provider (receiver) Referral API e-Referral Service - FHIR API
Provider (receiver) Booking API e-Referral Service - HL7 V3 API
Patient Booking User interface

e-RS includes a patient-facing application for appointment booking - see e-Referral Service for details


From 111 to general practice (GP) hub

For referring patients from an NHS 111 service provider to a general practice (GP) hub, use the following:

Use case Service or standard Notes
Service discovery - look up the patient's registered GP Personal Demographics Service - FHIR API

Use this to look up the patient's registered GP - as an ODS code.

This is needed to feed into the Directory of Services (see below).

Service discovery - find a suitable service Directory of Services - Urgent and Emergency Care - SOAP API

There is also a REST API but this isn't suitable for referrals from 111.

The Directory of Services (DoS) includes complex business logic to determine the best option for the patient.

For example:

  • it knows which services are bookable and which are not
  • given the patient's registered GP practice, it will determine which GP hub is appropriate for the patient
  • it has rules on which referrers a given provider is willing to accept
Booking

NHS Booking API (preferred)

GP Connect Appointment Management - FHIR API

Booking is optional, depending on the service being referred to. If a booking is done, it is done before the referral information is sent, not after.

The NHS Booking API is preferred because it handles slot searches better. A slot search via the GP Connect API returns all slots for all GP hubs on the same "instance" of the GP system, not just for a single GP hub.

Currently, TPP SystmOne uses the NHS Booking API and EMIS Web and Cegedim Vision both use GP Connect.

111 systems must support both APIs and use the appropriate one depending on the receiving system.

Referral NHS 111 API standard This is an API standard that is implemented point-to-point between sender and receiver. We do not have a central callable API to broker the requests. We do, however, have an adaptor that the receiver can use to transform inbound SOAP requests to FHIR.

From 111 to emergency department (ED)

For referring patients from an NHS 111 service provider to an emergency department (ED):


From 111 to urgent treatment centre (UTC)

For referring patients from an NHS 111 service provider to an urgent treatment centre (UTC), use the same approach as for referrals from 111 to GP hubs.


From 999 to 111

For referring patients from a 999 service provider to an NHS 111 service provider, use the Booking and Referral - FHIR API.


From anywhere to general practice (GP)

For referring patients from anywhere to the patient's registered general practice (GP), use the following:

Use case Service or standard Notes
Service discovery

Personal Demographics Service - FHIR API

Use this to look up the patient's registered GP - as an ODS code.
Service discovery - from 111 Directory of Services - Urgent and Emergency Care - SOAP API For details, see referrals from 111 to general practice (GP) hub.
Booking - look up endpoint for registered GP system Spine Directory Service - FHIR API You need the physical endpoint for the registered GP system before you can use the GP Connect Appointment Management API.
Booking - business functions GP Connect Appointment Management - FHIR API

You can book in at a specific practice but not with a specific practitioner.

GPs offer timed slots as well as untimed slots - essentially a call back that could happen at any time in a given period.

Referral - from 111 NHS 111 API standard  
Referral - from other GP or GP hub N/A

When referring from GP to GP (or to GP hub), there is no separate referral flow. Rather, referral information can be included with the GP connect booking using the description or comment fields. The GP Connect API specification says that these fields should not be used for clinical information, but that rule was relaxed during the COVID pandemic to allow referral information to be included with the booking.

Referral - from elsewhere e.g. online consult system GP Connect Send Document - FHIR API  

From patient to general practice (GP)

A patient arranging to see their GP is essentially a self-referral. They consider themselves to be booking an appointment, but they usually also provide some details on what the problem is - i.e. referral information.

There are a number of ways that patients can book an appointment (i.e. self-refer) with their GP:

  • in person, at the practice
  • by telephone
  • via a GP-provided patient portal where the patient can register for an account and book appointments
  • via the NHS App
  • via other third party software

The NHS App and third party software options use IM1 Pairing for integration with the GP system.


From patient to 111

A patient can self-refer to 111 by:

  • calling 111
  • using 111 online

For more details, see When to use 111.


From secondary care to general practice (GP)

For a transfer of care from secondary care to general practice (GP), use one of the following APIs:

Note that in some cases, these interactions can be considered as the 'feedback' step of a referral from general practice to a hospital or clinic.


From optometrist to eyecare clinic

For referring patients from an optometrist to an eyecare clinic, use the Eyecare Electronic Referral Service API standard.


Other use cases

If your use case isn't included on this page, contact us.

Last edited: 18 May 2022 5:04 pm