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Case studies

Covering lessons learned and personal experiences, these case studies provide an insight into the implementation, benefits and use of the NHS e-Referral Service (e-RS) across primary and secondary care.


Patient case study - Alex Dwiar, a patient at Paxton Green Group Practice, South London, talks about his experience of the NHS e-Referral Service (e-RS).

Clinical commissioning groups

As part of an initiative to manage demand for outpatient appointments, Cambridgeshire and Peterborough Clinical Commissioning Group (CCG) introduced e-RS Advice and Guidance (A&G) in all 105 GP practices, 4 providers and some community services. 

Primary care

St Clements Surgery Birmingham - Dr Gaspar and his practice have made significant cost and time savings, improving patient care, and achieved a reduction in Did Not Attends (DNAs) since they started using e-RS to make outpatient referrals.

Cambridgeshire and Peterborough - Find out more about what the health community in the region think about the improved e-RS Advice and Guidance function by watching this video.

Hedge End Medical Centre, Southampton - Dr Karl Graham is the IT lead at his practice, and supports the rest of his colleagues to promote the correct use of e-RS. Since using e-RS, the team have been able to identify significant benefits. 

Encompass Healthcare, Tyne and Wear - Dr Ashley Liston explains how it's possible to provide a very personal service with e-RS, and provides patients with a considerable degree of confidence of an appointment date, rather than having to wait with the uncertainty of when an appointment is going to arrive.

Bournemouth and Poole - This case study describes how e-RS has helped the Bournemouth and Poole Primary Care Trust (PCT) transform their referral pathway for physiotherapy services. This resulted in an improved standard of referrals received through better quality information, and with no delays in the patient pathway. 

Leeds Teaching Hospitals - The Physiotherapy Department at Leeds Teaching Hospitals Trust (LTHT) has been receiving referrals into its service via e-RS, and is now seeing significant benefits for themselves and their patients.

Sunderland - Using e-RS has improved the quality of the referral process for both patients and clinicians in Sunderland. The e-RS system has improved patients' experiences by increasing their involvement in the referral process.

NHS Trafford CCG - Trafford CCG have adopted a proactive and positive approach to help ensure that all referrals to Two Week Wait services are made through e-RS. Dr George Kissen, NHS Trafford Medical Director, wrote to all GPs, and practice managers to encourage them to use e-RS for their Two Week Wait referrals.

Secondary care

Cambridge University Hospitals NHS Foundation Trust - Proactively managing Appointment Slot Issues (ASIs). 

Calderdale & Huddersfield NHS Trust - Successfully implemented advice and guidance across all specialties, working closely with local CCGs to reduce the number of inappropriate referrals and to provide a clinically effective service that can bring benefits, including shorter waiting times and improved capacity.

Portsmouth Hospitals NHS Trust - The urology team are now realising the benefits of their clinicians using e-RS to review referral information and accept, redirect or reject referrals as appropriate, resulting in savings both in the patient pathway and administrative overheads.

Doncaster and Bassetlaw Hospitals NHS Foundation Trust - They use e-RS to help them better respond to the needs of patients across their local health community. 

Sherwood Forest Hospitals NHS Foundation Trust - This case study highlights how e-RS has improved the quality of electronic referral reviews for all patients, and greatly reduced the length of time to deliver appropriate patient appointments.   

Pennine Acute Hospitals NHS Trust - e-RS has helped the Pennine Local Health Community to significantly improve their referral processes and patient care.

Royal Devon and Exeter Foundation Trust - They use advice and guidance to support teledermatology services, streamline patient pathways and to help reduce the pressure on outpatient services. 

The University Hospitals of Morecambe Bay NHS Foundation Trust - Reviewing sample of 100 e-Referral Service (e-RS) referrals against 100 paper referrals has helped the organisation to understand the patient benefits. From an analysis across 20 clinical specialities, the findings revealed that on average patients received an appointment 8 days faster when referrals were made via e-RS.

Yeovil District Hospital NHS Foundation Trust - Find out how the organisation achieved paper switch off in November 2017.

Imperial College integration of Clinical Referral Information - This case study focuses on enabling effective referral management processes using Application Programming Interfaces (APIs) at Imperial College Healthcare.

Advice and guidance

Gloucestershire Hospitals NHS Foundation Trust - This case study focuses on the successful implementation of the NHS e-Referral Service (e-RS) advice and guidance functionality at the Gloucestershire Hospitals NHS Foundation Trust.

Taunton and Somerset NHS Foundation Trust - This case study focuses on the successful implementation of the NHS e-Referral Service (e-RS) advice and guidance functionality at the Taunton and Somerset NHS Foundation Trust.

York Teaching Hospital NHS Foundation Trust - This case study focuses on the successful implementation of the NHS e-Referral Service (e-RS) advice and guidance functionality at the York Teaching Hospital NHS Foundation Trust.

Last edited: 3 December 2019 1:38 pm