Referrals and appointments newsletter October 2026

This month’s edition highlights continued progress in making referrals and appointments simpler, more transparent and easier to manage for patients and staff. Referral notifications are now giving patients greater visibility while they wait, the first phase of elective Single Point of Access functionality has been introduced, and larger e-RS file uploads will support the sharing of more complete clinical information.

Alongside continued growth in NHS App coverage and usage, this month’s impact story demonstrates the practical difference our service can make for patients and providers. As we move through the next phase of delivery, our focus remains on scaling what works, supporting local adoption and building a more joined-up referrals and appointments service across the NHS.

At Medway, an acute trust in the South East, the missed-appointment rate among NHS App users was 16% lower than the trust average between June and August 2026, releasing capacity for other patients awaiting treatment. The trust’s use of digital questionnaires through the NHS App across all specialties contributed to a trust-wide waiting list reduction of 756 patients, helping to validate demand and enabling patients who still required care to progress more quickly.

Visit our FutureNHS Impact page for more information on the impact of our services for patients, staff and providers.

Patients referred through the NHS e-Referral Service (e-RS) now receive automated updates via the NHS App, providing greater visibility and reassurance while they wait. Since 11 September, patients have been notified when their referral is being processed and when it has been accepted by the receiving provider. More than 2.5 million notifications have been generated since launch across NHS App, email and SMS channels. Notifications are delivered through the NHS App and integrated with NHS Notify, enabling communications to be sent through the most appropriate channel where required. Please note that referral acceptance does not mean an appointment has been booked. NHS England continues to monitor feedback and operational impacts across the wider system. Visit FutureNHS NHS App Referral Notifications for more information.

The first phase of functionality supporting elective Single Point of Access (SPoA) was introduced earlier this month. It includes:

• the ability for providers to designate specific e-RS services as SPoA services
• a new 'Single point of access' label, helping referrers and provider users distinguish SPoA services from other service types when searching for services or making onward referral
• an update aligning the e-RS Pathway start date with RTT policy requirements
• the ability to record the referrer’s advice intention

Visit the dedicated Single Point of Access or e-RS pathway start date pages for more information.

The October release supports file attachments of up to 100 MB through the e-RS web-based application and API-connected systems. Some existing systems, including GP clinical systems, may continue to limit attachment uploads to 5 MB.

Review our news article about changes to file attachments in e-RS and find out how the changes affect APIs.

Access Referrals and Appointments guidance, FAQs, reports, dashboards and implementation support in one place.

Explore the FutureNHS Self-Service Toolkit.

This short survey for NHS trusts will help us understand trusts’ existing integration landscapes and workflows, and the functionality required to support adoption of a digital patient-initiated follow-up (PIFU) service. Complete the survey by 29 October 2026.

North East and Yorkshire: Humber Teaching - View Referrals and Appointments (first TPP trust - a major milestone that paves the way for further mental and community health providers to go live with appointment management).

North West: East Cheshire - Notifications and Messages (for Appointments).

South East: Frimley Health - Amend and Cancel Appointments.

South East: Oxford Health - View Referrals and Appointments.

South East: University Hospitals Sussex - Digital patient-initiated follow-up (PIFU).

Referrals and Appointments Reference Group - 20 October 2026

National Training Forum - 21 October 2026

Join our FutureNHS workspace.

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