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Pathway start - NHS e-Referral Service

Changes made to the date value in the NHS e-Referral Service (e-RS) to support accurate capture of the Referral To Treatment (RTT) clock start.

Pathway start date

What has changed

Due to a large number of requests from the NHS, the e-RS Programme investigated how the information about the ‘e-RS Pathway Start Date’ could be seamlessly integrated into Patient Administration Systems (PAS) to support more accurate capture of the Referral To Treatment (RTT) clock start. In response to the queries, we made changes to allow provider systems to receive and utilise the ‘e-RS Pathway Start’ date without any changes to their integration with e-RS.

Previously, when a booking was received, the majority of PAS derived the RTT clock start as the date and time that the booking message was received as there was no specific RTT data sent in the message. Due to how e-RS is now used, the date of a booking message was not always the correct RTT start date if the referral (UBRN) had been through any type of Assessment Service or resulted in an Appointment Slot Issue (ASI). Therefore, the e-RS Programme explored how to pass the information about the ‘e-RS Pathway Start Date’ by re-purposing the ‘Date of decision to Refer’ date field in the booking message (this date was not widely used) and sent the ‘e-RS Pathway Start Date’ in its place. Once this information was passed in the booking message, Patient Administration Systems started consuming this new date information passed in the message instead of deriving the clock start from the booking date. The change which replaced the ‘Date of Decision to Refer’ date with the ‘eRS Pathway Start Date’ took place in the April 2018 release of e-RS.

Please note that as this was just a change to an existing date field, which was known to be not widely used, no partner testing was undertaken. If any suppliers have any questions, they can contact the e-RS Programme team via: enquiries.ers@nhs.net

Example

e-RS made the change to send the ‘e-Referral Pathway Start’ date in the ‘Date of Decision to Refer’ field in the message instead of the ‘UBRN Created Date’ which was previously sent. See example below.

Previously, e-RS sent the ‘UBRN Issued’ date in the booking message (see screenshot below).

Screenshot showing the UBRN issued date

After the change, it now sends ‘e-Referral Pathway Start’ date, which is displayed to the service provider in various places in the e-RS front end (see screenshot below).

Screenshot showing the e-Referral pathway start date in the highlighted column

The ‘e-RS Pathway Start Date’ is derived as one of either:

  • the first booking of a referral (UBRN)this may be into a first outpatient service, or if the referral is first booked into any type of interface service (or referral management service) and is then subsequently referred on to a consultant-led outpatient service, it will be the first booking that starts the RTT clock
  • when a referral appears on a provider’s appointment slot issues (ASI) worklist
  • when a referral appears on the referrals for review worklist, if sent to a referral assessment service (RAS)

Please note that while e-RS can send the e-RS known pathway start date, this may not always be the exact RTT start date and as a result service providers must always ensure the correct RTT start date is recorded accurately.

Last edited: 23 October 2019 11:41 am