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Benefits of using the NHS e-Referral Service advice and guidance

The NHS e-Referral Service (e-RS) combines electronic booking with a choice of place, date and time for first hospital or clinic appointments. Learn more about the benefits of advice and guidance, and when it can be used as an alternative to a referral.

Find out how using advice and guidance can benefit all e-RS users.


Provides patients with quicker access to consultant advice than a face-to-face appointment may allow.

Allows patients to make more informed decisions on specialist care with their GP/referrer.

Helps to ensure that patients have had the necessary tests and treatment at the most appropriate point in the referral pathway.

The patient only starts the formal referral process once appropriate advice has been received (indicating the best clinical pathway or management route) or the advice and guidance request is converted to a referral by the provider.

Reduces the risk of re-directed hospital referrals and unnecessary hospital appointments.

Helps ensure patients are seen and treated in the right place, at the right time as quickly as possible.


Provides greater confidence that the referrals reaching secondary care are appropriate for that setting.

Helps to support GPs’ awareness of alternative services available within the community setting.

Reduces the cost of redirected or returned referrals.

Can be used to prioritise demand in high volume elective care specialties.

Offers an alternative digital pathway to referrers, which may result in less face-to-face referrals and cost savings for the commissioning organisation.

e-RS advice and guidance functionality is available nationally to all GPs and trusts, in contrast to commercial advice and guidance platforms.

e-RS provides access to a rich single source of data in the form of enquiries, reports and extracts.

Requesting clinician

Provides rapid referrer access to specialist advice on individual patients, including recommended primary care investigations, interpretation of results, treatment, and appropriateness or route for onward referral if required.

Provides secure digital two-way communication between primary and secondary care using the standardised e-RS portal.

Provides an accessible record of advice and guidance communication for patient care, service evaluation and audit.

Reduces the risk of a redirection or rejection of a referral and will better ensure that the correct services are offered to a patient at the point of referral.

May enable the patient to be managed in a community setting, with no need to refer to a secondary care organisation.

Provides a valuable education resource to guide healthcare professionals with future management of patients.

Can reduce timescales for patient treatments by accessing provider clinicians directly.

Service provider organisations, consultants, provider clinician teams, e-RS leads, service managers and service definers

Ensures clinic capacity is directed to patients who need to be seen by a specialist, meaning more cost-effective use of clinician time and expertise.

Provides more elective specialist advice digitally rather than face-to-face, which allows flexibility of service delivery and reduces pressure on clinic space and administrative services.

Provides an education resource for teaching healthcare professionals and doctors in training which may help with the future management of patients.

Provides a digital record of advice and guidance communication for patient care, service evaluation and audit, providing advantages over telephone, paper and e-mail advice and guidance.

An advice and guidance request, converted into a referral, allows clinicians to see the entire conversation with any attachments, enabling visibility of the whole referral pathway at the point of referral.

Allows consultants to specify inclusion and exclusion criteria for advice and guidance services (as for clinic referrals) in the directory of services (DOS) and regularly review the DOS in e-RS.

Advice and guidance requests can be accessed and responses can be sent remotely, at any time (within agreed turn-around times), providing flexibility in service delivery.

Advice and guidance can be incorporated into a clinician's schedule through local negotiation.

May reduce demand in high volume elective care specialities with long waiting times by improving patient care at the primary and secondary care interface.

Advice can be given regarding appropriate diagnostic tests or treatments required before an appointment is booked.

Referrals can be directed to the correct consultant, which is especially useful if named clinician referrals are enabled.

Patients referred to a clinic following advice and guidance may be further along their care pathway and may require fewer follow up appointments in secondary care.

Helps ensure that the patient's pathway is kept to a minimum and that delays are not introduced due to the need to redirect patients.

If only clinically appropriate patients are booked into a clinic, there will be an ease on the demand for a service, as inappropriate patients are not taking appointment slots that are needed by others.

If the patient is booked into the right place at the right time, less administrative time is taken up ensuring the patient is moved and seen by the correct service.

Gives access to system data to show how using advice and guidance can reduce outpatient appointments and supports use of tarrifs, service review and capacity demand management.

Watch a video explaining the benefits of Advice and Guidance.

Last edited: 13 July 2022 10:28 am