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Best practice guidance - NHS e-Referral Service

Generic guidelines for organisations providing services to NHS patients and their responsibilities in the NHS e-Referral services (e-RS).


This page is aimed to help organisations comply with the contractual requirements of the NHS Standard Contract and understand the importance of using e-RS correctly, to deliver safe and effective patient care. The guidelines described here should be recognised and implemented in all organisations providing services to NHS patients, so that all patients, wherever they are in England, experience the same high quality access to NHS care. It should be recognised that responsibility for the effective implementation of e-RS should be shared between organisations. For example:

  • providers are responsible for ensuring that services are made available on e-RS and that patients can book into appointments using the system
  • referrers are responsible for using e-RS effectively to find suitable services for their patients
  • commissioners are responsible for ensuring that services available on e-RS accurately represent the clinical needs of their patient population and that referrers and providers use e-RS effectively for the benefit of all patients

Find out more information about detailed responsibilities for the organisations below:

Generic guidelines

Users of e-RS must be appropriately qualified, trained, and compliant with required information governance standards. Find out more about information governance

Clinicians are responsible for any decision to delegate clinical actions within e-RS to non- clinicians.

Certain aspects of the system require clinical input, such as selecting clinically appropriate services, and reviewing referral information. Other tasks can be more appropriately carried out by administrative support staff, such as booking or re-scheduling appointments. Review the clinical responsibilities when delegating roles information for guidance about appropriate delegation.

Appropriate members of the clinical or administration teams must monitor worklists on a daily basis, to support effective management of referrals. Find out more about training on the management of worklists (N3/HSCN connection required to access this link).

Technical support teams must ensure that the correct equipment, infrastructure and user support is in place to enable optimum use of e-RS in all appropriate workplace environments.

Managers must ensure that operational policies (for example access or referral management policies) reflect the guidelines described in this page and that all relevant staff adhere to them.

Find out more about tools provided by the NHS Interim Management and Support (IMAS) intensive support team.

Further support available

Additional advice and support for all users of e-RS can be requested from the national e-RS team mailbox. For any support requests please contact the team via:

The e-RS website contains a wealth of useful information for patients and NHS staff, including training and educational materials.

e-RS users may wish to subscribe to the regular bulletin to be kept up to date with useful information about both the current system and future developments.

Last edited: 7 September 2020 8:40 am