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Referrers: advice and guidance changes in January 2021

The NHS e-Referral Service (e-RS) introduced functionality which will affects referrers when they create an advice and guidance request.


Changes have been introduced which will allows referrers to authorise advice and guidance requests to be converted to referrals by the provider, where appropriate.

Creating an advice and guidance request - what's changed?

When creating an advice and guidance request, referrers will notice tick boxes. These appear under the question: “Do you authorise the provider to convert this advice request into a referral if appropriate?”.

The tick box options are:

“Yes – I will ensure adequate clinical information is supplied”

“No – I only require advice at this time”

Image of the advice request details screen with the new tick boxes highlighted and the tick boxes enlarged as an overlaying image

Neither of the authorisation tick boxes are selected on entering this screen. Once the advice request details have been completed, a tick box must be selected before the request can be sent.

Users will notice to the right of the tick box question is an information icon. Hovering over this will display further information related to the question being asked.

image of the information displayed when hovering over the information icon on the advice request details screen. This reads “Selecting “Yes” means that you are passing authority to the provider to convert this advice and guidance dialogue into a referral, if they feel this is clinically appropriate. You should only select “Yes” when you are satisfied that this is the best option for the patient, they are content with the selected provider and adequate clinical information is available for the provider to proceed with this as a referral.”

Once the comments field has been completed and an authorised tick box selected, the ‘Send Request’ button will be enabled.​

Image of the advice request details screen with all information completed and ‘Send Request’ button enabled.

Referrers can update the authorisation to convert field after the request has been sent to the provider by opening the request from the Advice and Guidance worklist and making the relevant changes.

All actions are logged in the UBRN history.​

The e-RS pathway start will capture the date on which the provider converts the referral.

Reviewing the converted advice and guidance request information - what's changed?

Converted advice and guidance requests display on the referrer’s Advice and Guidance worklist. In the ‘Response Status’ column the referral will show as ‘Update Available – Referral Accepted’ 

Image of the new ‘Response Status’ on the Advice and Guidance worklist with the status enlarged.

Selecting the UBRN from the Advice and Guidance worklist will allow the referrer to view the full conversation including the final referral comment.​

​From this screen the referrer can 'Print' the information to update the patient record or select the ‘Remove From Worklist’ option which will remove the entry from the referrer's worklist, as the advice and guidance is now a referral.​ ​No further advice and guidance dialogue is possible.

Image of the Advice Request Details screen with the new ‘Remove From Worklist’ button displayed.

Additional information

  1. When providing authorisation to convert:​
  • Ensure the appropriate clinical information is attached​
  • Ensure the patient is happy with the chosen provider​
  1. Authorisation to convert an advice and guidance request can be changed by the referrer.​
  2. When a referrer selects the ‘Remove From Worklist’ option the advice and guidance will no longer appear on any referrer worklists; it is now the responsibility of the provider to manage the referral.
  3. Referrers can find the current status of the referral from the patient activity list.​
  4. Commissioners can use the existing information in e-RS (AG01 and EBSX02) to monitor and report on conversion rates.​
  5. Where any form of referral management exists, providers and commissioners need to work together to agree local processes.

Supporting information

Review the advice and guidance changes - early 2021 to see background information and further key points relating to these new changes.

Last edited: 17 June 2021 9:07 am