Specialist advice and single points of access

As part of its planned care transformation programme, NHS England is introducing an Elective Single Point of Access (SPoA) model to create a single route for the receipt, triage and management of specialist advice and elective referrals.

Supporting this change, the NHS e-Referral Service (e-RS) will introduce enhancements to its API for Advice and Guidance (A&G) and SPoA referral workflows.

This page provides a high-level overview of the planned changes, their expected impact on integrated software, and any actions suppliers may need to take.

The initial set of API enhancements includes:

• SPoA service definition
• clinical intent for A&G requests

What we are doing and why

As providers implement SPoA services, these will be represented within our Directory of Services (DoS).

This enhancement updates service search and healthcare service retrieval capabilities to enable integrated systems to identify SPoA services. This will help direct referrers to the appropriate entry point for specialist advice and elective referrals, while supporting the wider adoption of SPoA models across elective care.

Who will be affected

All partners integrated with these endpoints:

• Patient service search (A010)
• Retrieve healthcare service (A033) / Search for healthcare services (A035)

Patient service search (A010)

Partner systems use the patient service search endpoint to identify services that are clinically appropriate for a patient. The endpoint does not currently provide a way to identify whether a returned service has been configured as a SPoA.

The endpoint will be enhanced to include a new singlePointOfAccess Boolean field in the existing Extension-eRS-ServiceSummaryView-1 FHIR extension.

Retrieve healthcare service (A033) / Search for healthcare services (A035)

Partner systems use the healthcare service endpoints to retrieve detailed information about a specific healthcare service, including the information needed to support service selection, terms of use and contact information.

These endpoints will now include a new characteristic coded as SINGLE_POINT_OF_ACCESS

What you need to do

Partner systems using these endpoints will be able to identify services configured as a SPoA.

Suppliers should review their service search and healthcare service retrieval workflows to determine how SPoA services will be presented to their users.

This is an additive change. No existing functionality is being removed or altered.

What we are doing and why

NHS England is enhancing A&G to capture a referrer's clinical intent when seeking specialist advice.

Referrers will be required to select one of four nationally-defined clinical intent categories:

1. Advice to support management in primary care
2. Advice to confirm whether a referral is needed
3. Interim clinical advice while waiting for a referral appointment
4. Advice for an existing hospital patient

Capturing this information will enable NHS England to better understand how A&G is being used across referral pathways, measure advice outcomes and support the continued development of referral management, elective SPoA and planned care transformation initiatives. The clinical intent will not be visible to service providers.

We will be introducing a new mandatory parameter AdviceRequestClinicalIntent to capture the intent. This will be part of the existing eRS-CreateAdviceAndGuidance-Request-Parameters-1 FHIR array.

Who will be affected

All partners integrated with the Create advice and guidance request (A044) endpoint.

What you need to do

Ensure your integrated system can accommodate the new mandatory parameter by following the guidance below.