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Providers of indirectly bookable services

Where services are indirectly bookable, they are not linked to a patient administration system (PAS) and therefore patients must ring the service/clinic to book their appointment. This guidance describes how indirectly bookable services (IBS) can book and manage referrals online using the NHS e-Referral service (e-RS).

The patient enquiry

To be able to review a referral at an indirectly bookable service, the patient must first contact the service and book an appointment. There are two stages to this:

1.  Find the patient using the Patient Enquiry

screen shot of EPS system displaying how to find the patient using the patient reference number 2.  Booking an appointment

When you look up a patient using the Patient Enquiry, before an appointment is booked, the referral status will say Unfulfilled with a blank Appointment column.

screen shot of EPS showing book an appointment screen

To book an appointment for the patient:

  • click on the UBRN hyperlink and the Actions dropdown to reveal the actions available
  • from the actions list, select Book Appointment, which will open the Appointment Details screen
  • secure a suitable appointment date/time in your PAS and input this information into e-RS

screen shot of ERS showing an example of e-RS appointment details

  • click on the Submit button to record the detail
  • in the Appointment Details screen, click the Close button to complete the action

Please note that any actions carried out in e-RS when booking/cancelling/rebooking appointments must be mirrored in your PAS and vice versa.

Review, accept or reject a referral

Referrals will appear on the Referrals for Review worklist once an appointment is booked and referral letter/clinical referral information is attached.

  • with the Worklists tab open, use the filters available to view appropriate referrals
  • you can filter referrals by worklist type, service, clinician, specialty, location and referral type.

Reviewing referrals

  • select an appropriate UBRN to review
  • this opens the referral and shows a summary of the referral details
  • if a referrer sends referral information from their GP system then the Clinical Information column will display this as a series of headings
  • it can be viewed by selecting each heading and/or printed by selecting the Clinical Information Summary option from the Print button drop down
  • otherwise referral letters will be located and accessed via the Attachments section
  • click on the blue hyperlink to open/review/print the referral letter

e-RS screen shot showing a reviewing referral screen during the indirectly bookable service for service providers process

Accepting Referrals

  • once you have reviewed the referral and decided it is clinically appropriate for the clinic, select Accept, Review Next in the Review Referral Summary screen
  • when you accept a referral, e-RS will automatically show the next UBRN on the worklist for review

Once accepted, the referral will be removed from the worklist. To find a referral after it’s been accepted you can use the Patient Enquiry with either the patient’s NHS number or appropriate UBRN.

screen shot of e-RS showing the accepting referrals screen

Rejecting Referrals

  • once you have reviewed the referral and decided that it is clinically inappropriate for the clinic, select Reject in the Review Referral Summary screen
  • select a reason from the Reason dropdown list and enter further information in the comments field
  • this information will be visible to the referrer and help them understand why the referral has been rejected
  • select Submit, Review, Next

screen shot of e_RS showing how to reject referrals screen


  • a warning message will appear, asking you to confirm whether or not you have cancelled the appointment in the PAS
  • if you select Yes, no further action is required
  • if you select No the UBRN will appear in the Indirectly Booked Appointments to cancel in PAS worklist and will require further action
  • cancel the appointment in PAS, according to your usual processes. 

Rejected referrals will be removed from the worklist and returned to the patient’s GP. You will be able to find it via the Patient Enquiry but only for six months after the rejection.


Redirecting a referral internally

To redirect a referral to another service internally once the information has been reviewed you can use the change service function. Whenever you redirect a referral the patient should be involved in the process.

  • with the Review Referral screen open, select the Change Service button
  • the Service Selection screen allows you to make changes to priority, specialty/clinic type etc.
  • either make any appropriate changes or leave the search options as they are
  • select the Search All option
  • from the services shown select an appropriate (internal) service.

Note: If you see a service highlighted in orange, this is the service that the referral is currently booked with

  • Either complete an appointment booking online or select the Cancel Appointment/Rebook Later option if the service is indirectly bookable (See changing an appointment section to complete the booking)
  • Select an appropriate option from the warning message that appears

screen shot of e_RS showing how to redirect a referral internally

  • select Submit at the next screen to complete the action
  • ensure the appointment is changed in the PAS, in line with the appointment booked in e-RS

Note: referrals cannot be redirected once they have been accepted.

Changing an appointment

If it is necessary to change an appointment, this should be recorded in e-RS. Whenever you change an appointment the patient should be involved in the process.

Rebooking an appointment

  • in the Referrals for Review worklist, find the appropriate UBRN and open it
  • from the actions available select the Rebook Appointment option
  • input the new appointment date and time details, select a Reason for Rebooking and input any comments
  • select Submit to record the details
  • select an appropriate option from the warning message that appears
  • select Close at the next screen to complete the action
  • ensure the appointment is changed in PAS, in line with the appointment booked in e-RS

Cancelling an appointment

  • find the appropriate UBRN  (this can be found using the Patient Enquiry) and open it
  • from the actions available select the Cancel Appointment option
  • select a cancellation reason and input any comments
  • ensure that the tick box next to Cancel Appointment Request is not ticked otherwise the referral request will be cancelled along with the appointment and cannot be reinstated
  • some cancellation reasons will default to cancel the request e.g. treatment no longer required
  • select an appropriate option from the warning message that appears
  • select Cancel Appointment to complete the action
  • The referral will appear on the Appointments for Booking worklist and can also be found using the Patient Enquiry.

screen shot of e_RS showing the cancelling an appointment screen


Last edited: 6 September 2021 1:30 pm