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.

Future service roadmap

The e-Referral Service roadmap shows:

  • system enhancements
  • when they're being delivered
  • deadlines for the levers and incentives for using the service

Levers and incentives

The Quality Premium for 2016/17

The Quality Premium for 2016/17 is an incentive payment to encourage Clinical Commissioning Groups (CCGs) to increase the number of patients referred electronically through e-RS. 

It includes payments for:

  • achieving 80% of first outpatient appointments via e-RS
  • a 20% point uplift in year

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:

CQUIN guidance 
Directory of Services 
Clinical Assessment Services 
CQUIN template 

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.

Also in this section



Enhanced advice and guidance

Find out about enhanced Advice and Guidance, which has been delivered in 2 phases


Follow-up appointments

Information and updates about follow-up appointments.


Advanced reporting

Information and updates on the advanced reporting enhancement.


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.


Enhancements to the Appointment Slot Issue process

Enhancements to the Appointment Slot Issue (ASI) process will be introduced from March 2018 onwards, to allow for a more simple and efficient process.


Paper switch off programme and documents

Working with referrers, providers and commissioners, we've created a guide to support the delivery of paper switch off in a local health community. You can also download the referenced documents.