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The future of the NHS e-Referral Service

Thanks to user feedback, the NHS e-Referral Service (e-RS) is continually improving to make it easier, quicker and more convenient to use. Find out about the improvements we're making and our user feedback process.

NHS e-Referral Service vision

"To provide NHS and partner organisations with a referral service that empowers patients to obtain the best care - first time, every time.​"

NHS e-Referral Service principles

Visual representation of the NHS e-Referral service principles

  1. Enabling patients and professionals to manage referrals in partnership.
  2. Providing a single source of information on referrals and bookings into health and social care services.
  3. Providing a standard tool to support the management of health and social care referrals.
  4. Supporting patients in completing referral and booking transactions online, including provision of assisted digital options.
  5. Making data and information readily available to support patient choice, clinical pathways and health and social care planning.
  6. Simplifying the referral process and supporting national standards of integration and interoperability.
  7. Promoting a modern approach to software design and development.
  8. Developing a high-quality solution that delivers significant benefits and makes the NHS more efficient.

Future service roadmap

The e-Referral Service roadmap shows both system enhancements and when they're planned to be delivered.

User feedback process

Thanks to user feedback, the NHS e-Referral Service (e-RS) is continually improving to make it easier, quicker and more convenient to use. This helps e-RS to support your needs and provide a better user experience.

You can provide suggestions on how to improve e-RS by requesting a ‘user need request form’ from

The diagram below shows how these requests are processed.

Flow chart explaining how requests to e-RS are processed.

All user needs are added to the e-RS requirements log and grouped into ‘themes’ of areas of the system, for example the Directory of Services or Worklists. When any system change is being explored in these areas, all existing user needs are reviewed and fed into the research process to confirm – or otherwise – their inclusion in the future system development. If users indicate that they would like to be included in the research process, they will be contacted by the e-RS programme research team as work is planned in the relevant functional area so they can be involved with other users.

Levers and incentives

e-RS and Advice and Guidance Commissioning for Quality and Innovation

This is a payment to incentivise providers to publish all services and appointment slots on e-RS.

The aims of a CQUIN (Commissioning for Quality and Innovation) are

  • to secure improvements in the quality of services
  • better outcomes for patients

The e-Referral Service CQUIN (section 7) aims to support referrers, such as GPs, in referring their patients electronically to the full range of outpatient services available and for their patients to always be able to book an appointment. 

The incentive will help ensure that hospitals and other providers are encouraged to make the necessary outpatient services and appointments available on e-RS.

If you're a provider, these resources will help you meet the CQUIN requirements:

Directory of Services 
Clinical Assessment Services 

Advice and guidance

The advice and guidance CQUIN (section 7) requires providers to set up and operate advice and guidance services for non-urgent GP referrals, allowing GPs to access consultant advice prior to referring patients into secondary care. Deliverables in the e-RS roadmap will help providers meet the targets set out in the advice and guidance CQUIN.

This case study explains how the Royal Devon and Exeter Foundation Trust use advice and guidance to support teledermatology services, streamline patient pathways and to help reduce the pressure on outpatient services.

The Standard Contract for 2018/19

The Standard Contract for 2018/19 requires the full use of e-RS for all consultant led first outpatient appointments.

From 1 October 2018, providers will only be paid for activity resulting from referrals made through e-RS. Further guidance will be released in 2017, explaining non-payment arrangements. This will support local health communities to plan for the Paper Switch Off for elective referrals.

Related pages

  1. internal

    Advanced reporting

    Information and updates on the advanced reporting enhancement.

  2. internal

    Referral Assessment Services

    This page details new functionality, which has been introduced to provide the ability to triage referrals before booking an appointment for patients. This supports complex clinical pathways and helps to reduce demand to elective care services.

  3. internal

    Enhancements to the Appointment Slot Issue process

    Following enhancements to the Appointment Slot Issue (ASI) process introduced in March 2019 further improvements will be introduced in July 2019 (subject to final testing). This will make the process more efficient for providers.

  4. internal

    Paper switch off

    All 150 acute hospital trusts and GP practices have made the move to sending and receiving all first outpatient referrals through the NHS e-Referral Service (e-RS)

Last edited: 8 July 2019 1:35 pm