eRS Use Case

The e-Referral Service (eRS) project creates paperless referrals from primary to secondary care. For example from GP to a clinic or hospital.

This can be done by the primary care setting (i.e. a GP, more commonly a receptionist), or by the patient themselves given a Unique Booking Reference Number (UBRN).

Benefits of eRS

Enabling NHS paper free vision. Alleviating the Administrative Burden. Faster Referral Processing Enabling patients and professionals to manage referrals in partnership. Providing a single source of information on referrals and bookings into health and social care services. Providing a standard tool to support the management of health and social care referrals. Supporting patients in completing referral and booking transactions online, including provision of assisted digital options. Making data and information readily available to support patient choice, clinical pathways and health and social care planning. Simplifying the referral process and supporting national standards of integration and interoperability. Promoting a modern approach to software design and development. Developing a high-quality solution that delivers significant benefits and makes the NHS more efficient.

Use of UK Core

• Appointment
• ServiceRequest
• Slot
• Schedule
• HealthCareService
• Task

User Story Summary

As a primary care referrer, I can:

• create a new e-referral
• search for relevant patient services to create a shortlist
• access existing e-referrals
• create a triage request for the Referral Assessment Service (RAS)
• upload and manage a patient letter or attachments, linking them to a referral
• retrieve appointment slots and book appointments
• defer a booking to a provider if an appointment slot is unavailable

As a secondary care provider, I can:

• access referrals as a worklist
• retrieve non-clinical information (meta-data) about the referral
• retrieve attachments which are linked to a referral or triage (RAS) request
• retrieve clinical information which has been provided by a referrer
• accept or reject a referral request
• retrieve Advice & Guidance (A&G) conversations and send responses
• convert Advice & Guidance (A&G) conversations into a referral

So that

• Advice is received quickly from Secondary Care

Which in turn allows

• Referrals for treatment in Secondary Care to be booked quickly by either the patient or Primary Care provider at a location, date and time which is suitable for the patient.

Main Course

Advice

1. The Patient or Carer presents at the doctor’s surgery or via telephone / web call / web meeting
2. The GP deems the condition valid for further consultation by a secondary care clinician
3. The GP enters/searches for the patient in the GP system
4. The GP enters the request type into the referral system
5. The GP selects the type of work request – Advice Referral
6. The Advice Referral is actioned by the secondary care clinician
7. The clinician responds to the Advice Referral
8. The Advice Referral reply is actioned by the GP
9. The GP responds to the patient using advice from the secondary care clinician
10. The patient requires no further referral into secondary care.

Alternative Course

Appointment

1. The Patient or Carer presents at the doctor’s surgery or via telephone / web call / web meeting
2. The GP deems the condition valid for further consultation by a secondary care clinician
3. The GP enters/searches for the patient in the GP system
4. The GP enters the request type into the referral system
5. The GP selects the type of work request – Advice Referral
6. The Advice Referral is actioned by the secondary care clinician
7. The clinician responds to the Advice Referral
8. The Advice Referral reply is actioned by the GP
9. The GP decides that the condition need a secondary care referral/appointment
10. The existing work request is used to create a referral request for an appointment
11. The type/speciality and location parameters are entered into the system
12. A referral is made for the patient into secondary care.
13. The patient is given a referral letter informing them or how to book their own appointment
14. The patient log into the website to create/manage their referral, e.g. NHS choices ‘Manage Your Referral’ using Unique Booking Reference Number (UBRN)
15. The patient logs in
16. The patient is presented with their referral details
17. The patient chooses their appointment date and time and location
18. The patient confirms and books their appointment.
19. The clinician Accepts the referral appointment.