Referral and appointments newsletter February 2026

The Referrals and Appointments service continues to support delivery of elective reform priorities, with progress towards March 2026 commitments on NHS App coverage and appointment availability. The growing use of appointment notifications and management in the App is helping trusts reduce missed appointments, free up clinic capacity and support improvements in Referral to Treatment (RTT) waiting times performance.

Advice and Guidance (A&G) via the e-Referral Service (e-RS) plays a key role in managing demand and reducing unnecessary referrals. As set out in national policy, the e-RS will be used for all primary care requests from July 2026, and we are working with systems and suppliers to support readiness. Further information on the new A&G interface will shortly be published on the e-RS website. 

In parallel, we are progressing plans to enable single point of access (SPOA), supporting more standardised, clinically-led referral routes, better triage and more consistent access to specialist care.

This month also marks an important milestone for digital patient initiated follow-up (PIFU), a key enabler of more efficient outpatient pathways. The PIFU Design History is now live (see overleaf), setting out the evolution on national designs and supporting documentation.

Across the London region, trusts using the NHS App have seen a 25% lower did not attend (DNA) rate for missed appointments than those that don’t over the last three years.

Each month, London patients are viewing around 540,000 outpatient appointments and 430,000 related letters and documents through the NHS App. By giving patients access to appointment details within minutes of booking, rather than waiting for postal letters, the NHS App makes it easier for patients and providers to rearrange or cancel their appointments, allowing earlier rebooking and more efficient use of clinic slots.

Visit our FutureNHS Impact page for more information on the benefits of the NHS App for patients and staff.

123 NHS trusts live in the NHS App, with 99 of these trusts live with additional App features.

Recent go lives:

London:

Moorfields Eye Hospital - Notifications and Messaging (N&M) (for questionnaires)

North East London - N&M (for appointments)

Tavistock and Portman - N&M (for appointments)

North East and Yorkshire 

Newcastle Upon Tyne - Documents and N&M (for appointments and documents);

South West Yorkshire - N&M (for appointments)

North West

Greater Manchester Mental Health - Core features and N&M (for appointments)

South East

East Kent - Documents, Paperless Preferences, Management Information (MI) v2 

NHS App campaign

The national campaign is now live, encouraging people to get the most from key NHS App features including notifications for appointments. Running until 15 March, the campaign includes radio, national press and social media. It’s free to register for the Campaign Resource Centre and use the materials.

Directory of Services (DoS) review 

NHS England is working towards the implementation of a standardised naming convention for all e-RS services on the e-RS Directory of Service (DoS). This will require all organisations to review and update their services on their DoS to ensure they are appropriately aligned with the new speciality and clinic types. See the guidance to support providers.

The patient initiated follow-up (PIFU) design history is now live on the referrals and appointments design history website. This design history brings together key
milestones, showcases how the PIFU designs have evolved over time, outlines the differences between patient engagement portal (PEP) enabled PIFU and national PIFU, and provides the documentation that explains how we have reached this point.

A design history shows how a service has developed and why key decisions were made, so teams can understand the service, use and improve it over time. 

In December, we delivered the first PIFU pathway in the NHS App, integrated via the Netcall PEP at Rotherham. National PIFU will follow with a pilot launch expected in the first quarter of 2026/27.

Referrals and appointments supplier forum - 10 February 
Referrals and appointments reference Group - 24 February 
e-Referral Service (e-RS) training forum - 3 March 

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Access guidance on our services, demos, resources and promotional guidance to support trust and patient communications.