e-RS Advice and Guidance (A&G) allows referring clinicians to seek advice from provider clinicians, allowing consultants and other hospital clinicians to provide support to GPs in relation to a patient’s condition. Use of A&G helps to reduce unnecessary hospital referrals and minimise the need for face-to-face appointments.
Advice and Guidance
Remember – e-RS now allows providers to set-up ‘Advice Only’ services which may help providers to manage the current situation.
Find out more by reviewing the advice and guidance toolkit.
Clinical referral review and triage
Quick reference guides have been created to support the switch to clinically triaging referrals online via e-RS. The following guides include reviewing and triaging referrals on the appointment slot issue and referrals for review worklist:
Patient Reminder Letters
The reminder letters in e-RS prompt patients who have not booked an appointment to proceed with the booking. From the 25 March 2020, e-RS will temporarily suspend sending reminder letters for any Routine priority referral. This applies to referrals which have not had an appointment booked and where a patient’s appointment has been cancelled. Reminder letters for 2ww and Urgent priority referrals are unchanged and will continue to be sent at the same frequency.
Monitoring provider worklists
Providers should closely monitor the appointments for booking worklist which displays all referrals (UBRNs), including those that have had their appointment cancelled, either by the GP practice, the telephone appointments Line (TAL) or the patient themselves via the Manage your referral website. Referrals are displayed in order of their clinical priority. For example: 2WW, urgent and routine. In addition to appearing on this worklist, the referral will also be visible on the referring GP practice’s worklist, so they can also see that an appointment has been cancelled and needs to be re-booked.
All referrals that are cancelled will appear on the appointments for booking worklist, so it is important, while many appointments are being cancelled, that providers manage this worklist carefully.
If providers are receiving an increased number of referrals (UBRNs) on the appointment for booking and appointment slot issue (ASI) worklists it is recommended that worklist filters are used to limit the list of referrals (UBRNs) displayed. For example: filtering the worklist by a specific specialty, location and/or service will reduce the number of referrals being returned. Use 'Reset all filters' to return to the original view or select an alternative filter.
Find out more information about worklist filters (N3/HSCN connection required).
Remember – As confirmed above, reminder letters for Routine priority referrals have been temporarily suspended. Patients will still receive reminder letters for 2ww and urgent referrals if their appointment has been cancelled.
These will be sent after one day (for 2WW referrals) and eight days (for urgent referrals).
This is an important safety net, ensuring that referrals do not get lost or appointments missed.
If providers are re-booking patients, they may like to consider using the new patient booking window functionality to ensure that appointments are only made available in the required timescales. If no appointments are available, re-bookings will come to the provider as appointment slot issues, in which case no further reminder letters will be issued.
Find out more from the Help section of e-RS (N3/HSCN connection required).
Patient booking window
In February 2020, new functionality was introduced in e-RS to allow providers to set a ‘booking window’ for each clinical priority that a service supports.
As part of the management of routine and urgent capacity, providers can ensure patients are able to book a future outpatient appointment within a specified booking window.
Remember – if appointments for routine referrals need to be cancelled, then using the patient booking window functionality will ensure that those referrals cannot be rebooked, either by the patient, their GP practice or the appointments line, outside of the routine appointment ‘window’, for example, into appointment slots within the booking window defined for urgent appointments.
However, the provider can rebook, if required (as in this example), any cancelled routine referral into an urgent priority slot.
Find out more about the patient booking window.
Telephone assessment service (TAS)
e-RS supports referrals into several different service types; outpatient appointment, assessment or triage services, which could be used to support on-line or telephone consultations.
One of these service types is the telephone assessment service (TAS). The TAS appointment date/time should be agreed with the patient and the process clearly explained, so that the patient understands what method the clinic will be using to contact them, for example via telephone or an online consultation.
Contact email@example.com if you would like more information on using TAS to support your transition to telephone and on-line consultations.
Use of instructions in the directory of services (DoS)
Within the definition of each service on the DoS, providers can use the ‘Instructions’ section to relay information to patients. These are then displayed on the appointment summary page (for referrers) and printed on the appointment confirmation when a patient books their appointment or displayed onscreen in the Manage your referral patient booking website.
Providers should use the ‘Instructions’ section to advise patients of the next steps or how their appointment will be delivered, whether via telephone or online consultation, for example.
The EBSX02 extract is now available daily to support providers with the daily management and planning of outpatient referrals, including appointment slot issues or monitoring cancellations etc.
Find out more from the reports and extracts pages on our website.
Business continuity plans
As part of each organisation’s business continuity plans, arrangements should be made to ensure key staff continue to be able to access e-RS via a corporate or trust device which is smartcard enabled and is able to access HSCN/N3 via the corporate network. Please contact your IT team for further assistance.
The e-RS team is working with colleagues across NHS Digital, NHS England, Department of Health and Social Care (DHSC) and our development partners to ensure service continuity and to respond as needed to the changing situation.