Commissioning in the NHS e-Referral Service

There are two types of provider services within the NHS e-Referral Service (e-RS); those that are available to all referrers in England, and those that are only available to referrers who belong to a specific organisation.

The first of these is typically consultant-led and available to all referrers to allow patients to exercise their right to choose a clinically appropriate provider for their referral.

The second group of provider services require a ‘parent’ commissioning organisation to make these services available to selected local referrers. Once these have been ‘commissioned’ within e-RS, only those referrers within the commissioning organisation are able to see and select these services for their patients. Within e-RS, the service provider can select whether or not to include the services they are setting up ‘on the Secondary Care menu’ and by opting to do this, they are making the service available to everyone. All other services will have to be commissioned within e-RS and will require start dates (and optional finish dates) added within the system by the commissioning organisation to make them visible to local referrers.

Setting these start (and finish) dates within e-RS is called setting up a ‘Commissioning Rule’.

To set up ‘Commissioning Rules’ in e-RS someone within the commissioning organisation must have a valid smartcard to which the business function of B1106 – Maintain Commissioned Services, has been assigned. Learn more about e-RS business roles.

When opening e-RS using the Commissioner role the Commissioner builder screen is displayed. The Commissioning builder in e-RS will only display services that are not on the 'Secondary Care Menu':

To find a service, first search on the specialty of the service.

The specialties are accessed via a drop-down box and are displayed in alphabetical order.

There is no need to add a clinic type to your search but you can do this and it may reduce the number of organisations that are returned.

Once you have selected the correct speciality click the load button.

Some specialities may take longer to return services than others. This is because the system will be displayed under the provider name.

Each service you wish to make available at each individual location will need to be selected separately.

Clicking on the desired location name reveals the services.

To commission the service on e-RS enter a start date in the Effective Date Range field on the right of the screen.

No further fields need to be completed to make the service available to the referring practices after this date has passed.

Once a date has been entered, the Save button will become available.

Each service should be saved as it is commissioned.

Next to the name of the service will appear the letter ‘C’ indicating the service is now commissioned by your organisation.

Services that have never been commissioned by your organisation will display an ‘N’ next to the service name.

The ability to commission a service for a commissioning organisation and all its referring organisations is available as basic functionality, but there are two additional features available to support commissioners:

• the ability to commission a service at an individual referring organisation level
• the ability to copy commissioning rules from one commissioning organisation to another

Commissioning at referring organisation level will allow commissioners to ensure certain services are only visible to selected referring organisations. For example, it might be useful to be able to make a specific localised service available to a small number of referring practices within a larger commissioning organisation.

This functionality ensures that the locally commissioned service is not actually visible to the other practices within the commissioning organisation, thereby avoiding potential confusion for referrers.

This may be beneficial to a commissioning organisation which covers a large geographical area and which has locally commissioned services that they wish to make available to only selected referring practices.

By clicking the arrow next to Apply to all my organisations you can see which services the commissioning rules can be applied to.

When the service is commissioned at the organisation level all the referring organisations below will automatically be ticked.

If the commissioning organisation wants to make the service only available to certain referring practices then they should deselect all those not needed.

Copying commissioning rules from one commissioning organisation to another supports the reorganisation of commissioning organisations, for example merging or demerging, without the need for extensive preparation work within e-RS and helps ensure continuity of services for referring practices.

This functionality allows a user (with the e-RS Commissioner role), via a Commissioning Rule enquiry, to copy any commissioning rules already set by another commissioning organisation.

If commissioning organisations are merging and a new organisation is created, a commissioner will need the e-RS commissioner role in the new organisation added to their smartcard.

To copy the commissioning rules from one commissioning organisation to another:

Log in as the commissioner for the new organisation.

Run a commissioning rule enquiry.

Commissioning rules can either be copied at organisation level as shown in the steps below or specialty level by selecting the relevant specialty from the drop-down box

To find the commissioning organisation that the commissioning rules are to be copied from click on the ellipse and enter the organisation name and search

Highlight the organisation name from the search results.

Click done.

The organisation selected is now visible in the Commissioning Organisation box.

Ensure the box ‘Currently Effective Only’ is ticked.

Click Search.

Select the services to be copied.

Select the Copy button.

If you wish to set new dates for the new commissioned services untick Copy Contract Details.

Enter a new start date.

If you are coping the rules due to a merger ensure the start date is before the date the referring organisations is due to move to the new organisation.

Select Submit.