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Paper switch off programme and documents

Working with referrers, providers and commissioners, we've created a guide to support the delivery of paper switch off in a local health community. You can also download the referenced documents.

The Standard Contract for 2018/19 requires the full use of the NHS e-Referral Service (eRS) for all consultant-led first outpatient appointments. From 1 October 2018, providers will no longer be paid for activity resulting from referrals not made through eRS. This is known as 'paper switch off'.

The icon paper switch off implementation pack [691.22KB] details the recommended approach to the project, from establishing project governance and set-up, to business process change, along with:

  • associated guidance
  • templates
  • sample documents from PSO pioneer trusts gathered to date

It may be possible to do some of the activities at the same time, or in a different order to suit your local project requirements. You might not need to do every activity, depending upon your current starting point and level of eRS utilisation.

If you require further information, contact your NHS Digital Implementation Manager (details are in the implementation pack).

Find out the latest paper switch off (PSO) dates for NHS Trusts.


Successful paper switch off sites

Digital Health hosted an e-RS and paper switch off webinar on 22 September, delivered by NHS Digital, NHS England and also in partnership with Sherwood Forest NHS Trust, which was the first trust in the country to achieve paper switch off. Watch a video recording of the webinar:

NHS e-Referral Service (e-RS) - how will the new Standard Contract impact you-20170922 1037-1 from Katerina Loucka on Vimeo.



Bolton foundation NHS trust are the third trust in the country to achieve Paper Switch Off. In this video, Lisa Galligan-Dawson explains their approach to achieving this, and offers others some tips from their learning along the way:


Documents referenced in the implementation pack

icon 20170515 ERS Letter to Trusts and CCGs [163.08KB]
icon 2nd sample generic highlight report template [115.13KB]
icon Advocacy referrals [270.5KB]
icon Automatic email reply example [14.04KB]
icon Cancelling and rescheduling appointments [490.5KB]
icon Consultant retain-rebook appointment [149KB]
icon Consultant triaging [291.5KB]
icon CDD e-Referral paper switch off progress report template [110.73KB]
icon CDD sample eRS project risk and issue log [23.45KB]
icon CDD sample PID [62.44KB]
icon Draft FAQs SFHFT electronic referrals (wc 17-05-08) [86.21KB]
icon eRS draft action plan v0.8 [55.13KB]
icon eRS draft action plan primary care [48.38KB]
icon eRS draft action plan primary care v0.6 December 2017 [48.38KB]
icon eRS paper switch off project plan v0.9 [136.5KB]
icon eRS pioneer lessons v1.0 [1.28MB]
icon eRS programme board TOR sample [27.64KB]
icon eRS PSO generic highlight report template [34.1KB]  
icon eRS PSO project board ToR [27.86KB]
icon eRS PSO project risk issue log template [28.23KB]
icon eRS PSO project steering group ToR [27.42KB]
icon eRS sample engagement pack 1 June V0.2 draft [2.77MB]  
icon eRS steering group TOR sample [27.35KB]
icon Exclusions from Sherwood and eRS [21.35KB]
icon Frimley specialty waves letter [26.56KB]
icon GP communications - Yeovil flyer [564.27KB]
icon GP email for paper switch off - Yeovil [51.72KB]
icon HEY PaperRejection_Proforma_May2017 [2.17MB]
icon How to redirect an appointment [386.5KB]
icon Kings_communication to CCG's re PSO [25KB]
icon Kings_ GP bulletin - 2wws on e-RS [128.5KB]
icon Local paper referrals reporting form following PSO by specialty - sample [35.24KB]
icon NHS e-Referral Service draft action plan v0.7 including links [55.13KB]
icon NHS e-Referral Service utilisation data quality v2 [80.02KB]
Patient case study - Alex Dwiar - Paxton Green Group Practice
icon Programme board agenda sample [33.56KB]
icon Project initiation document template v2 [147.08KB]  
icon PSO highlight report - template 0.1 [299.12KB]
icon Sample agenda e-Referrals PSO kick-off meeting v0 2 270417 [27.04KB]
icon Sample CCG bulletin messages [17.38KB]
icon Sample data pack [131.72KB]
icon Sample ongoing process - routine paper referrals into a 1st consultant led clinic [192.32KB]
icon Sample pilot phase process - routine paper referrals into a 1st consultant led clinic [193.33KB]
icon Sample process - 2WW and urgent paper referrals [185.36KB]  
icon Sample project plan 3105 [50.92KB]
icon Sample project plan 2 3105 [38KB]
icon Sample report - CCG clinical executive - eRS [83.57KB]  
icon Short form PID template v1 [60.24KB]  
icon South sites paper referral notification of paper switch off_ Bromley CCGs [35.5KB]
icon Switch off readiness checklist 3105 [27.38KB]
icon Sample process - 2WW and urgent paper referrals [185.36KB]
icon Standard Operating Procedures [304.5KB]
icon Walsall NEW PSO PG Version [94.86KB]

Have a question about the e-Referral Service? Please contact enquiries@nhsdigital.nhs.uk.

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