NHS e-Referral Service

The e-RS is a digital platform that provides an easy way for referrers and service providers to manage their patients’ journeys. Users can: 

• create referrals for patients
• book appointments or select services for triage
• change or cancel appointments
• have advice conversations with other users
• add to and select from the Directory of Services (DOS)
• download and create reports and extracts

It's designed to help professionals make more informed choices and manage referrals end-to-end. 

The e-RS is designed for a range of roles within the NHS care setting, including:

Clinical roles

These users are directly responsible for patient care. Referring clinicians refer patients to service provider clinicians, who then assess patients for their condition. They can also have advice conversations with each other.

These users support the referral process. They may create referrals on behalf of clinicians, log information and manage appointments.

These users are responsible for making the e-RS available for their healthcare settings and have access to data to support business processes.

The e-RS enables these users to integrate and maintain services, register services on the Directory of Services (DOS) and gather data on referrals and appointments.

Patient information  

The NHS e-RS Service holds information about referrals. This includes the patient’s: 

• name 
• NHS number 
• Unique Booking Reference Number (UBRN) associated with referral 
• date of birth 
• sex 
• contact details (including address) 
• GP details 
• reason for referral 
• preferred healthcare providers or clinics
• health information related to the referral

The e-RS also holds information about patient appointments, including the: 

• date and time 
• location 
• additional requirements 

The e-RS uses this information to help patients find appropriate clinics, book and manage appointments. It also uses this information to help professional users involved in the referral process. 

This information is fully auditable. 

Read about how patient data is processed and used from the e-RS GDPR guidance and the e-RS patient privacy statement.

The e-RS contains a library of all available services that a patient can be referred to. This is called the Directory of Services (DOS). New services are added by service definers.

These services can be filtered by referrers and providers. The filters include: 

• speciality and clinic type 
• request priority (routine, urgent or 2-week wait) 
• appointment availability 
• distance from patient 

They are also categorised into bookable services, triage services and advice and guidance. 

Using specialist advice through e-RS

Referring clinicians can send advice requests to service provider clinicians. These are conversations to gain more information about a patient’s condition, or to assess the suitability of a prospective service.

These conversations are stored and can be downloaded as ‘advice summaries’. 

These are only accessible to clinician and admin roles and are deleted once a UBRN has expired. 

Read more about advice and guidance.

Reports and extracts 

The e-RS contains data about referrals called reports and extracts. These contain useful information about activity on e-RS, such as active referrals, appointment slots and user roles. 

Read more about reports and extracts.

The NHS Standard Contract includes a requirement for e-RS to be used for all GP referrals to NHS Acute outpatient, consultant-led services.

e-RS provides an easy way for patients interacting with their GP/referrer to be directed to a first hospital or clinic appointment with a specialist. It ensures that patients have choice at the point of being referred, of place, date and time for their first outpatient appointment in a simple and convenient way. The NHS also publishes an open data dashboard that shows e-RS usage by specialty and weekly increments.

If you're a healthcare professional, you need an official authentication method to log in to the e-RS application.

The e-RS can be accessed via the public internet, with users authenticated by CIS2. In addition to using smartcards, users can use security keys or Windows Hello for Business to log into e-RS. 

For more information, read point 6 on this page.

Service information, releases and planned maintenance.

System updates and events.

Service status (N3/HSCN connection required for this link).

Service level: Gold - e-RS provides a service which includes being available 99.9% of the time with 24/7/365 support. The service offers monthly management information reporting and a disaster recovery target of 4 hours.

System usage (based on January to December 2023):

• 70,000 average referrals per day
• 1.8 million advice and guidance requests
• 18.3 million initial referrals

Learn about our current work and future plans for e-RS.

You can also raise new feature requests for e-RS and vote on existing ones.