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All first referrals to Trusts will need to be made via the e-Referral Service and that paper referrals (including referrals made via email) will no longer be accepted by hospital Trusts from October 2018. 

. Our local trusts have decided to move to e-referrals only before this date:

  • 16 July - BHRUT will switch off paper referrals
  • 3 September – Whipps Cross will switch off paper referrals.

Sending referrals electronically using the e-RS is safer, faster and more secure than using paper/email. It enables practice and hospital staff to easily track a patient’s progress and eliminates the possibility of referral letters and appointment confirmations being lost in the post.

Best practice guidelines published by NHS Digital state that referral letters should be attached to appointment bookings within the following timescales:

  • Two Week Wait - within one working day
  • Routine referrals - within three working days. 

There is significant variation in the length of time that practices take to attach a referral letter.

As a starting point practices must attach referral letters within seven working days for routine referrals and within one working day for Two Week Wait referrals.

When making a 2WW referral on e-RS please ensure that:

  • The patient is aware that the referral is urgent and why it is urgent. It is also important that the patient is available to attend. If a patient is not available then the referral must be deferred until the patient can attend.
  • The patient should be given a hard copy of the specific 2WW referral patient leaflet which is embedded in each 2WW referral form. This is specific to the 2WW clinic type and explains what the patient should expect at the appointment (e.g. the likely investigations, how much time it will take etc).
  • Contact details for the patient are correct including telephone numbers.
  • The appointment on e-RS is made and agreed with the patient before they leave the practice - an appointment should not be booked without the patient’s agreement.   Should the patient wish to book their own appointment (this is not recommended), please explain to the patient how to make the appointment using web or national telephone appointment line (TAL). If the patient is making the appointment, the practice will need to monitor that the appointment has been made and contact the patient if this has not been done.

GP concerns 

We know that our GPs currently experience some difficulties in booking appointments via e-RS due to limited availability of appointments made by providers. To address this, our Trusts are working with us towards ensuring all specialties are available on e-RS along with adequate levels of available appointments.

In preparation for the 2018 ‘switch–off’, practices are urged to review their practice referral systems and ensure that staff are trained in using e-RS. If not already doing so, practices are asked to start to use e-RS as the sole means of referral where possible. 

Benefits to GPs

As you know, clinicians can also seek Advice & Guidance (A&G) via NHS e-RS on a range of specialities. Those currently available for BHRUT only are:

  • Cardiology
  • Clinical Haematology
  • Endocrine
  • Nephrology
  • Neurosurgery
  • Neurology
  • Rheumatology
  • Respiratory Medicine (previously known as Thoracic Medicine)
  • Ophthalmology 

Further information 

The CCGs and Trusts will be engaging with GPs and acute colleagues further in the coming months to support this work so watch out for further information, training and updates on the GP intranets.

The NHS e-RS website contains a wealth of useful information for patients and NHS staff, including training and educational materials:

NHS Digital have produced an e-RS training video (see below) which provides Practices with a step by step on how to: 

  • Making an “Advice & Guidance” request
  • Referral to outpatient appointment
  • Patient “managing your appointment”

nb: the video will starts 10 minutes in.

NHS e-RS users may wish to subscribe to the regular bulletin to be kept up to date with useful information about both the current system and future developments:

If you have any local queries related to this work, please contact:

© 2023 NHS Havering Clinical Commissioning Group.