Managing displaced appointments in the NHS e-Referral Service

The NHS e-Referral Service (e-RS) application can detect discrepancies between the appointments it believes to be booked and those held by the service's patient administration system (PAS). This functionality applies specifically to directly bookable services and is known generically as a displaced appointment. 

If a displaced appointment has occurred, it is important to note that: 

• the e-RS application does not cancel the booking - it simply flags the unique booking reference number (UBRN) as potentially displaced
• as far as the patient/GP/national telephone appointment line (TAL) are concerned, the booking is still valid
• e-RS cannot detect the opposite scenario where the PAS has a booking that e-RS does not 

Appointments that the e-RS application considers displaced are moved to a displaced appointments worklist. This can be viewed by the service provider to whom the appointment was booked. In addition to this, many PAS suppliers provide functionality and services that will help the trust with the identification and resolution of displaced appointments. 

Trusts should contact their PAS suppliers directly to ascertain what support is available.

When detected, the service provider needs to use the following process: 

1. Check the appointment details in the e-RS application for the affected UBRN.
2. Check the appointment details in the PAS to see if they match the e-RS application.

If the appointment details match then the service provider just needs to remove the UBRN from the worklist. To do this:

1. Select the UBRN
2. Click "actions"
3. Remove from the worklist

The user does not need to rebook anything in this scenario or contact the patient as the booking is still valid. The UBRN has probably been incorrectly marked as displaced because of a PAS messaging issue.

If the appointment details do not exist in the PAS anymore then the service provider should investigate why the appointment has been removed - for example, because of clinic cancellations. If the same appointment date and time can be offered then the appointment should be rebooked, preferably using the e-RS application, otherwise it should be manually booked in the PAS. If the same appointment date and time cannot be offered then the patient should be contacted and offered another appointment.