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Booking and Referral Standard

The Booking and Referral Standard (BaRS) is an interoperability standard for healthcare IT systems that enables booking and referral information to be sent between NHS service providers quickly, safely and in a format that is useful to clinicians. It will eventually be available in all care settings.

About BaRS

A patient journey - from the patient presenting with symptoms, to appropriate treatment then discharge - will often involve two or more NHS services. Booking, clinical and administrative information need to follow the patient at all stages of this journey. This often involves paper processes and using multiple healthcare IT systems which can be inefficient.

The BaRS ensures healthcare professionals receive the information they need, in a format they can use, integrated into their existing healthcare IT systems.

It will first be implemented within three care journeys:

  • between NHS 111 and emergency departments (also known as A&E)
  • between 999 and clinical assessment services (CAS) for referral
  • between 999 and clinical assessment services (CAS) for ambulance validation

You can monitor supplier progress in implementing BaRS on our supplier status page.

The experience gained from the two initial implementations will help to improve the standard ahead of making it available to all appropriate NHS services in England, such as pharmacy and dentistry, via their healthcare IT systems.

View the prioritised future use cases for BaRS

111 and Pharmacy

111 and Dental

GP and Pharmacy

111 and Out of Hours/Integrated Urgent Care Treatment

999 and Pharmacy

999 and Dental

999 and Urgent Treatment Centre

999 and Out of Hours/Integrated Urgent Care Treatment


What is an interoperability standard?

An ‘interoperability standard’ describes a standardised set of rules, that govern the format, language and delivery methods for transferring data or information from any healthcare IT systems to another. In the case of BaRS, it helps a service to send or receive booking and referral information to or from another care provider for the purpose of a patient's ongoing care.

If all care settings adopt the same interoperability standard for sending and receiving referrals, it makes it easier, faster and safer to move patients through their care journey.

BaRS supports NHS England's standards roadmap and priorities.

We are going to:
  • build the necessary national infrastructure and components that will underpin delivery of BaRS

  • provide a messaging standard that allows multiple systems to communicate with each other in a simple and logical way

  • publish a standard that supports the administrative task of booking a patient into their next care setting, as well as providing the correct and relevant clinical referral information to care givers so that they can make or accept a patient referral

  • produce a standard that is accepted, agreed and adopted by health care system providers and rolled out across the health system to improve patient experience and care outcomes

Benefits of the Booking and Referral Standard

National interoperability standards, such as BaRS and the digitisation of booking and referrals are important priorities for the NHS as described in the Long Term Plan, Future of Healthcare Vision and NHS Transformation Directorate Delivery Plan.

An interoperability standard for patient booking and referrals will have several benefits.

Patients will:

  • be able to efficiently book appointments and time slots with the service that's right for them
  • get the right advice and treatment when they most need it, safely and easily

Healthcare workers will:

  • receive the information they require, and in sufficient detail, to enable them to undertake the patient care activity requested
  • be able to triage the patient without asking them to unnecessarily repeat information already collected earlier in their journey
  • send and receive booking and referral data that is integrated into existing healthcare IT systems - this avoids working across 2 or more applications or systems and saves time

IT suppliers and care providers should find it easier and more efficient to implement a single, agreed national interoperability standard, rather than supporting the multiple and varied standards currently in operation.

Commissioners and Integrated Care Systems will find it easier to integrate care journeys across care settings using existing systems.

recent government report has acknowledged the work already done in this area and the benefits of sharing booking and referral data between healthcare IT systems and across care settings:

The join up of 111 and accident and emergency (A&E) departments through digital information has helped keep A&E departments safe by enabling 111 to directly book GP, pharmacy, and outpatient appointments.

Implementation guide

Supplier status

These resources are still being refined and added to as we develop the standard. Any of the content may be subject to change.

Clinical safety

Throughout each development cycle of the standard, the BaRS programme will consider and maintain patient clinical safety through ongoing clinical risk management activities.

The Clinical Safety Standards listed below are mandatory under the Health and Social Care Act 2012. BaRS programme and supplier responsibilities for each of the standards are described underneath.

DCB0129: Clinical Risk Management: its Application in the Manufacture of Health IT Systems

  • The BaRS programme is responsible for implementing DCB0129 to achieve endorsement from the NHSD Clinical Safety Group
  • Suppliers are responsible for implementing DCB0129 to achieve Clinical Authority to Release

DCB0160: Clinical Risk Management: its Application in the Deployment and Use of Health IT Systems

  • Suppliers are responsible for compliance with DCB0160 to manage clinical safety for their local deployment


The clinical safety case is currently in development. Contact us if you would like a copy or need further information.

Information governance

An NHS England Direction to enable NHS Digital to develop an interoperability standard for patient record systems and a related application programming interface (Booking and Referral Standard Service) has been published for the BaRS programme. A record will also be added to the NHS Digital GDPR Register.

Information standards notice

We're working with the Data Alliance Partnership Board (DAPB) to publish BaRS as an Information Standard. A corresponding Information Standards Notice will be issued to support adoption and use of the Standard.

Contact us

Use our online enquiry form to ask a question, request more information about the project or Standard, or to simply leave your feedback.

Further information

internal NHS e-Referral Service

The NHS e-Referral Service (e-RS) combines electronic booking with a choice of place, date and time for first hospital or clinic appointments. Patients can choose their initial hospital or clinic appointment, which they can then book online (a telephone service is also available) or in the GP surgery at the point of referral.

internal GP Connect

GP Connect allows authorised clinical staff to share and view GP practice clinical information and data between IT systems, quickly and efficiently.

Last edited: 25 May 2022 5:20 pm