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Getting started advice for referring staff

The NHS e-Referral Service (e-RS) has been successfully implemented in referring organisations across England. This page provides considerations and advice when starting to implement e-RS.

Using e-RS for the first time

If you are planning to begin using e-RS for the first time, or if you are an existing user and want to maximise the benefits, visit the e-RS referrers webpage for guidance and recommendations based on best practice.

To use e-RS to promote your services to referrers and manage referrals correctly, you will need to consider the following areas.

Identify appropriate people to lead this work

It is recommended that one person in the practice is nominated as a project leader for the implementation of e-RS. This person can then become the local “expert” and liaise with the Clinical Commissioning Group (CCG) representatives and IT suppliers and ensure that implementation runs as smoothly as possible.

A lead GP should be nominated to deal with any decisions that have a clinical bearing. This person will better understand the viewpoint of clinical colleagues and help to influence those individuals.

Your CCG or Commissioning Support Unit (CSU) should have an e-RS lead who can guide you through the implementation of e-RS.

Roles and responsibilities

Decide how you are going to use e-RS within the practice and consider what role each user will have in terms of handling patient referrals.

e-RS is a role-based application; all staff members that are using the system will need a smartcard with the appropriate access rights. Each person logging on to e-RS will have different areas of the application available to them depending on those access rights.

Your local CCG or CSU will have a registration manager and registration agents who will be able to advise you on required smartcard roles and organise smartcards for all staff members, both clinical and non-clinical, within the practice.

Find out more information about smartcard registration.

Technical deployment

e-RS is a web-based application; users access the service via an internet browser web page, there is no software loaded onto your PC. However, if you are using a clinical system which has the capability to integrate with e-RS then your clinical system supplier will need to be involved with any implementation to enable that part of their software.


A range of education and support information can be found on the and through the e-RS system Help (N3/HSCN access required).

Clinical systems suppliers will provide local training on how their systems interact with e-RS.

Going live

You will need to decide if you will go live with all GPs at the same time or take a measured approach and include more GPs as time passes.

Work with your CCG/CSU lead and choose a date that you are going to commence using the system.

Ensure that your CCG/CSU lead, IT representatives and, where appropriate, your clinical system support team are available to support you. If you have a close working relationship with your local provider, let them know your plans.

Making referrals

There are many types of services available for referral within e-RS.

Find out more from the NHS Digital e-RS document library which provides overviews of the different services available, as well as information on requesting advice and guidance.

Last edited: 23 January 2020 1:28 pm