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Attachments - converting files to formats supported by the NHS e-Referral Service (e-RS)

The information on this page provides instructions on how to save unsupported files to different formats to allow them to be uploaded into the NHS e-Referral Service (e-RS).

How to manage unsupported file types in e-RS

The e-RS programme is making changes to the types of files that can be uploaded into e-RS. When a user attempts to add an attachment, of a file type that is not supported by the service, in the web-based version of e-RS (not through a GP integrated system) the message below will appear:

Image showing an ‘Attachment File Type’ error message.

The steps below detail how to change an unsuitable file into a type that is supported.

If an error message appears when uploading referral information that states the attachment type is not supported, please follow the steps below:

  1. Close the error message box.
  2. Review our supporting file types to understand what files are accepted and then save the attachment as a different file type (see the example process details below).
  3. Open the file and save it as a supported format.

Information or files may be stored in these supported formats:

  • Save as a PDF document (ideal for multi-page information such as discharge summaries)
  • Take a screenshot (ideal for small pieces of information, such as test results)
  • Take a snip (an alternative method of taking a screenshot and easy to redact confidential information, available on most computers)

Please also review the ‘Removing locally saved files from my device’ section.


Save a file as a PDF document

HTML file types

On a Windows computer, the HTML file will open in either Microsoft Edge, Internet Explorer,  Google Chrome, or Mozilla Firefox, depending on which browser is on the user’s computer.

Refer to the appropriate section below to follow steps on how to save the file as a PDF document:

Microsoft Edge
  1. Select the three-dot option (‘Settings and more’), usually found top right of the screen.
    Image displaying the three-dot option in Microsoft Edge
     
  2. Select Print from the menu.
    Image displaying the print option in Microsoft Edge
     
  3. The Print menu will appear, with a preview of what you are printing.

    Image displaying the print window in Microsoft Edge
     

  4. Select the PDF option from the ‘Printer’ dropdown.
     

  5. Change other options if required and select Print.
     

  6. Select where to save the PDF file.
     

  7. Upload the file to the referral.

Google Chrome
  1. Select the three-dot option menu (‘Customize and control Google Chrome’), usually found top right of the screen.
    Image displaying the three-dot option in Google Chrome
     
  2. Select Print from the menu.
    Image displaying the print option in Google Chrome
     
  3. Select the PDF option from the ‘Destination’ dropdown.

    Image displaying the Printing options available in Google Chrome
     

  4. Change other options if required and then select Print.
     
  5. Then select where to save the PDF file.
     
  6. Upload the saved file to the referral.
Mozilla Firefox
  1. Select the three-line option menu (‘Open menu’), usually found top right of the screen.

    Image displaying the three-line option in Mozilla Firefox
     

  2. Select Print from the menu.
    Image displaying the print option in Mozilla Firefox
     

  3. Select the PDF option from the ‘Name’ dropdown.
    Image displaying the print window in Firefox
     

  4. Select the PDF option from the ‘Name’ dropdown.
     

  5. Change other options if required and then select OK.
     

  6. Select where to save the PDF file.
     

  7. Upload the saved file to the referral.


Note: Please contact the local IT team if there are issues displaying the Print to PDF option.

The following section may help capture information from files that open in an application, rather than a browser window.


How to capture information from the screen and crop images

Users may wish to capture information being displayed on the screen. They may redact or crop unnecessary personal information before uploading the image to a referral.

Note: Capturing information as an image limits a user’s access to the information. For example, screen readers will not be able to interpret the detail within the image and they cannot copy and paste text from the image.

The following options capture information as images:

Using the Snipping Tool

With the information you wish to capture on the screen, search for the ‘Snipping Tool’ by using the search bar or the Start Menu located at the bottom of the screen (see image below).

Image of searching for the Snipping Tool using the search bar
 

  1. Select ‘Snipping Tool’ to open the application.

    Image of the Snipping Tool application
     

  2. Select ‘New’ from the toolbar, then drag your mouse to select the information you want to capture.
     
  3. Once captured, information can be redacted using the ‘pen feature’ to block out information you do not want to share.
    Image of the Snipping Tool application highlighting the pen option
    Image of captured information redacted
  4. Save the captured image by selecting ‘File’ from the Snipping Tool toolbar and then ‘Save As’. Ensure the file type of the image is supported by e-RS.
     
  5. Select where to save the image file.
     
  6. Once saved this can be uploaded to the referral.
Taking a screenshot

With the information you wish to capture on the screen, use the Print Screen button on the keyboard (the Alt and Print Screen buttons may need to be pressed together depending on the keyboard being used). This will save an image of the screen onto the clipboard.
Image displaying the Print Screen button
For users with more than one screen, the Ctrl button can be held, along with the Print Screen button (and Alt button if required) to capture the active screen.  

  1. Open an application, such as Word, Paint or Photos
  2. From the application right-click the mouse and select Paste
  3. If no amendments are required to the image, it can be saved or converted to a PDF file. Review the 'How to capture information from the screen and crop images' section below if areas of the screen need removing
  4. Once saved this can be uploaded to the referral
Cropping images

Some captured images may require cropping to remove personal identifiable data or confidential information. For example, the screenshot may include details not relevant to this patient, if the user has two screens.

If the image is opened in a Microsoft application, such as Word, Paint or Photos, the following steps can be followed:

  1. Each of the above applications will display a cropping icon on the toolbar and/or by right clicking the mouse. Ensure the image is selected to enable the cropping option.

    Image of cropping icon using Microsoft Word
    (Image of cropping icon using Microsoft Word)

    Image of cropping icon using Microsoft Paint
    (Image of cropping icon using Microsoft Paint)

    Image of cropping icon using Microsoft Photos
    (Image of cropping icon using Microsoft Photos)
     
  2. Use the sizing handles to remove the areas that are not required.
    Image showing the image with the sizing handles displayed in Microsoft Photos

    Image showing the image cropped
    (Image of cropping image)
     
  3. Once the resizing is complete, save the image and upload to the referral.
     

Note: It is recommended that images are cropped before saving the file as a PDF. If the image is opened in an alternative application to Microsoft Word, Paint or Photos, and no cropping function is available, the user can follow the guidance on the 'How to capture information from the screen and crop images' above to capture the information.


Removing locally saved files from my device

It is important to ensure any files saved locally to a device (for example, saved on the user’s desktop, c:\ drive, etc) are removed, as the information could contain personal identifiable data.

Copy any files to the appropriate patient record and attach them to e-RS before carrying out the following steps.

  1. Locate the file to be removed. This can be done by searching for 'File Explorer' using the search bar or the start menu located at the bottom of the screen (see image below).

    Image of searching for the File Explorer using the search bar
     

  2. From the File Explorer window,right-click the file, and select Delete.

    Image of the File Explorer window and the delete option

    The file has been moved to the ‘Recycle Bin’ and must now be removed from this location.

  3. Locate the ‘Recycle Bin’ on your device. On a Windows machine the ‘Recycle Bin’ icon maybe displayed on the Windows Desktop.

    Image of the recycle bin icon
    Double-click the icon to open the ‘Recycle Bin’.

    If the ‘Recycle Bin’ icon is not displayed on the desktop, follow either of the steps below to present the Run command box where the ‘Recycle Bin’ can be located:

  • If there is a Windows key on the keyboard, hold this down along with the ‘R’ key to display the Run command box.

Image of a windows keyboard highlighting the Windows and 'R' character keys

  • Use the search bar or the Start Menu located at the bottom of the screen and search for ‘Run’ and select Open.

Image of searching for the Run application using the search bar

When the Run command box appears, type in the ‘Open:’ field - explorer.exe shell: RecycleBinFolder and select OK.
Image of the run command box

Open the ‘Recycle Bin’, locate the file, and right-click to select the Delete option.
 

  1. With the ‘Recycle Bin’ window open, navigate to the file, right-click, and select Delete. The file has now been permanently removed from the device.
    Image of the recycle bin window and the delete option

If GP practice users are noticing an increasing number of referrals with outstanding referral letters in their integrated system, this may be due to the system rejecting incorrect file types which have been attached to the referral. It is important to monitor and action all worklists regularly, in addition to reviewing integrated system error logs.

Last edited: 8 June 2022 10:30 am