Patient notification enhancements in the NHS e-Referral Service

New notifications are being introduced for patients referred through the NHS e-Referral Service.

The notifications will give patients more information about the progress of their referral while they wait to hear from a hospital or clinic.

Patients may receive an NHS App notification, email or text message when their referral reaches certain points in its journey. The notification will explain the status of the referral and what the patient can expect to happen next.

Patients can sometimes receive little or no communication after a referral has been sent. This can leave them uncertain about what is happening, what they need to do or when they can expect an update. It can also lead to patients contacting NHS organisations for reassurance about the progress of their care.

The new notifications are an initial step towards improving the patient experience by providing timely and relevant information at important referral milestones.

These changes support the NHS Minimum standard for planned patient care, which all providers of planned care are expected to meet. Standard 1: You will know your referral is accepted ensures that patients and carers are not left uncertain about whether their referral has been received or processed.

NHS England will continue to monitor the effect of the notifications on patients, providers and the wider healthcare system, with future improvements informed by implementation experience, feedback, data and engagement.

A notification will be generated when:

• a referral is submitted to a triage service by the referrer
• a referral is deferred to a provider by the referrer as no appointment slots were available at time of booking (Appointment Slot Issue)
• a provider service records an ‘Accept and refer/book later’ triage outcome for a referral sent to a triage service or deferred to a bookable service

For routine referrals, the ‘if you do not hear by’ date included with the referral information will be reduced to 20 working days.

Notifications will be sent using the contact information available on PDS for the patient. The channel used will depend on whether the patient has the NHS App, has enabled NHS App notifications and has an email address or mobile telephone number available.

If the patient has the NHS App and notifications are enabled

An NHS App notification will be sent immediately.

If the NHS App notification is not read, an email will be sent after 24 hours.

If the email cannot be delivered, a text message will be sent after a further 24 hours.

If NHS App notifications are disabled or the patient does not have the app

An email will be sent immediately.

If the email cannot be delivered, a text message will be sent after 48 hours.

If no NHS App or email address is available

A text message will be sent immediately, where a mobile telephone number is available.

When the clinic is reviewing the referral

When a referral has been submitted to a triage service or deferred to a provider, the patient will be told that the clinic is reviewing their referral. The information will explain that the patient does not need to do anything at that stage and that the clinic will contact them with an update.

The patient’s NHS App referral information will provide relevant clinic and referral details. Where applicable, the date by which the patient should expect to hear and the clinic’s telephone number will be displayed.

Patients will also be able to view the referral through 'Manage Your Referral' (MYR), including information explaining that the clinic is reviewing the referral.

A text message may advise the patient that their referral is being reviewed, that the clinic will provide an update and whom to contact if they have not heard by the date shown. The message will also direct patients to NHS 111 if they need urgent help.

When the referral has been accepted

When a service records an ‘Accept and refer/book later’ outcome, the patient will be informed that their referral has been accepted and that the clinic will contact them about what happens next.

The NHS App will show the clinic’s contact details and relevant referral information. 

If the patient logs into MYR, they will also be able to see a similar message informing them that the referral has been accepted. 

The text message will tell the patient that the referral has been accepted, that the clinic will contact them about the next steps and provide a telephone number if the patient needs to contact the clinic. It will also tell the patient to call NHS 111 if they need urgent help.

The notifications are intended to improve visibility for patients while they wait, but they may also affect how and when patients contact GP practices and providers. NHS England will monitor operational impacts alongside patient outcomes and use feedback and data to inform further development.

These notifications are the first stage of this work. A future development is planned to introduce notifications after appointment bookings.
Feedback from trusts, providers, GP practices and patients will help shape how the notification service develops over time.