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Referrals and Appointments

Referrals and Appointments is the national digital service that connects how referrals, advice and guidance, and appointments are managed across the NHS. Through the NHS e-Referral Service (e-RS), the Booking and Referral Standard (BaRS) and NHS App appointment capabilities, it helps patients access care, supports clinicians and providers, and enables consistent digital pathways across planned care.

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About Referrals and Appointments

Referrals and Appointments is delivered through the following national services: 

e-Referral Service (e-RS) – manages referrals, triage, booking and Advice and Guidance between referrers and providers

Booking and Referral Standard (BaRS) – provides national APIs and data standards that enable consistent referral and booking journeys across systems 

NHS App (hospital and specialist appointments) – gives patients access to referral and appointment information through the NHS App 

Each of these services has its own service page with detailed guidance, onboarding information and technical documentation. 

Who the service is for

Referrals and Appointments is designed for everyone involved in a planned care journey, such as:             

Patients and Carers

People waiting for appointments, diagnosis or treatment

Individuals who need visibility of their referrals and updates

Carers who support others and need clear oversight

People using the NHS App, patient engagement portals (PEPs), or non-digital alternatives

Clinicians

GPs and primary care professionals making referrals

Hospital clinicians triaging, booking or providing Advice and Guidance

Community, mental health, diagnostic and pharmacy clinicians

Services coordinating step-down and follow-up care

Administrative and Operational Staff

Booking teams managing appointments and waiting lists

Referral centres coordinating demand and capacity

System partners (Integrated Care Systems, NHS providers) responsible for operational performance

Suppliers and Technology Partners

Electronic patient record (EPR) suppliers

Patient engagement portal (PEP) suppliers

Scheduling and triage system providers

Integration partners required to meet national API standards

Benefits

The Referrals and Appointments service provides a single, national approach to managing referrals, triage, and booking, improving access, consistency, and efficiency across the NHS.

For patients and the public

Faster access to care through reduced waiting times and improved pathway flow

Clear, consistent journeys regardless of location or provider

Greater transparency with real-time updates via the NHS App

More equitable access by reducing unwarranted variation

Improved experience with fewer delays, reduced duplication, and simpler processes

For clinicians and frontline teams

Reduced administrative burden through standardised processes

Clearer referral pathways and expectations, reducing variation

Improved triage and Advice and Guidance, avoiding unnecessary referrals

Better visibility of referral and booking activity to support decision-making

More stable, nationally aligned systems, reducing workarounds

For systems, providers, and ICSs

Real-time visibility of referrals, appointments, demand, and capacity

Two-way communication between patients and services

Reduced manual processes and duplication

Faster, more efficient pathways

Simpler, standardised ways of working across the system

How the service works

Referrals and Appointments connects local systems through national platforms and standards: 

•    Referrals and appointments are created and managed in existing local systems of record 
•    national APIs enable those systems to exchange information safely and consistently 
•    patient facing information is surfaced through the NHS App and other approved tools 

This approach supports interoperability without creating new central clinical records. 

What information is available

The service does not create new clinical records, but instead provides secure, standards‑based access to referral and appointment information held in local systems of record (such as GP systems, EPRs, PEPs, diagnostics systems).

Information includes:

Referral data

Referral requests, triage status, and referral outcomes

Advice and Guidance communication summaries

Linked tasks and required actions

Standardised referral templates where appropriate

Appointment data

Appointment details (date, time, location, specialty)

Status updates (booked, cancelled, rescheduled, completed)

Supporting documents (questionnaires, referral bundles, letters)

Notifications and alerts

Metadata (not clinical data)

Where the data is held: information used to direct the system to the correct GP, hospital or service where the patient’s record is stored

What each service can do: details about the technical connections available (such as which systems can send or receive certain types of information)

Who can access what: permissions and consent settings that control which organisations or services are allowed to view specific information

Referrals and Appointments uses national technical standards to enable NHS systems to share information safely and consistently. This includes Fast Healthcare Interoperability Resources (FHIR) UK Core and BaRS Application programming interfaces (APIs).

These standards ensure that:

  • information is shared securely
  • data is understood consistently across systems
  • the origin of data is clear and traceable

Clinical data is not stored centrally. It remains in the original system (for example GP systems or hospital records).

The national service provides a secure way to access information when needed, without duplicating or owning the data.

National usage policy

To support a consistent national service, a shared usage approach is applied across NHS-funded providers and suppliers. Referral and appointment journeys are delivered through national platforms and APIs, supporting referral management, tracking and booking across services.

Systems are aligned to common standards, including FHIR UK Core, BaRS and NHS App integration, helping to reduce reliance on bespoke local integrations over time.

Services are designed in line with NHS Service Standard and Secure by Design principles, ensuring that data access is appropriate, governed and auditable.

Inclusive access is also supported, with digital functionality complemented by safe non-digital routes such as telephone booking.

Core capabilities including appointment management, referral tracking, documents and notifications are enabled through national platforms and made available via the NHS App.

This approach promotes greater consistency while continuing to support innovation beyond the core service.

Roadmap

Referrals and Appointments is being developed through phased national delivery, with a long term aim of providing a fully joined up referral and booking experience across all planned care pathways. 

Future development focuses on: 

  • expanding coverage across community and mental health services 
  • increasing automation of routine administration 
  • improving real time visibility for patients and staff 
  • aligning funding and policy to scale proven solutions 

Detailed roadmap information and engagement routes are available on linked programme pages. 

Status, service level and current usage

Contact Us

Further information

internal National training forum - NHS e-Referral Service (e-RS)

The National Training Forum has been established to provide open and regular communication channels between the e-RS national training team and a representative panel of e-RS trainers (and/or representatives who are responsible for e-RS training) from the NHS and independent sector.

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Last edited: 9 October 2026 1:47 pm