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Joint guidance on the use of the NHS e-Referral Service 2018

An e-RS referral can be made into either a bookable service (in which case the patient needs to book an appointment before the referral can be processed further), or sent to a triage/assessment service, where the referral information is assessed first, without an appointment being pre-booked.

 The provider clinician should then view the referral information as soon as possible and make a judgment as to whether the patient has been booked into the correct service, with the correct urgency, or whether the timing of the appointment needs to change in light of the condition being referred.

If the provider clinician feels that their service is not clinically appropriate for the patient and/or there are more suitable alternative ways of optimising patient care, they may choose to return the referral and advise the referrer accordingly.

If accepted, the assessment service (not the GP) must identify suitable onward service(s) for the patient and contact them to offer a choice (where choice rules apply) and facilitate the booking of an appointment.

Provide the patient with instructions on how to select a clinic and book their appointment (printed instructions are currently provided in the form of a letter, but future enhancements will allow patients to receive electronic instructions if they wish).

If no appointments are available at the chosen provider, the patient can try an alternative shortlisted provider, or defer the referral request to the hospital or clinic and wait to be contacted with an appointment date (see Section 11 below).

These services, which are set-up by the provider in addition to, or instead of, a directly bookable service, are especially useful for complex pathways or scenarios where the patient might be booked straight to test or procedure, instead of needing an initial outpatient appointment.

The patient may then be referred to another service (for example - in the community, or in a secondary care setting), or advice may be sent back to the patient’s referring clinician to assist with on-going management.

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