[MI] NHS e-Referral Service Open Data October 2019 to April 2025

NHS e-Referral Service Inclusions

+ All patients that have had either a referral, booking or appointment slot issue, performed through e-RS

NHS e-Referral Service Exclusions

- This data does not include those patients that have had a referral, booking or attempted booking outside of e-RS

Methodology Update

With the publication of the NHS e-Referral Service (e-RS) provider (private) dashboard, the methodology of the NHS e-Referral Service (e-RS) open data dashboard has been updated to improve the accuracy and to ensure consistency between dashboards. As a result of the change in methodology, differences have been observed using a national count for a select reporting period. Details can be found in the 'New Methodology Comparison' document below. The data in the dashboard and open data files have been re-run using the latest changes in methodology.

Definitions and Caveats

Referral data

A referral in e-RS is defined as a request to another clinician to assist with management of a patient's health issue, this may result in creating an appointment request with a shortlist of suitable services, into one of which the patient may book an appointment. Each referral has a unique booking reference number (UBRN). Referral data includes initial referrals for all priorities, specialties, and clinic types. Two week wait (2WW) clinic types are displayed, all other clinic types have been grouped into 'Other clinic'.

Booking data

Bookings data includes the number of successful initial bookings made as the result of a referral.  A booking may be made at the same time as a referral, or at a later date.  It includes bookings of referrals previously on the Appointment Slot Issues (ASI) worklist, provided the provider updates the e-referral system with the booking information. For non-2WW bookings, this set of data includes First Outpatient bookings only. For 2WW bookings, the data includes bookings for all appointment types.  Only the first record of a converted Unique Booking Reference Number (UBRN) is counted (unique UBRNs). Subsequent activity such as rebooking is ignored.  2WW clinic types are displayed, all other clinic types have been grouped into “other clinic”.

Appointment Slot Issue (ASI) data

Appointment slot issue (ASI) data - during the appointment booking process e-RS will allow the referral to enter the ASI process if there are no slots available for booking at the time of the appointment search. This action is called “Defer to Provider”. Each time the referral is deferred the referral will appear on the service provider's “appointment slot issues” worklist. It is this action we are reporting.

The data represents every ASI action recorded during the reporting period. 2WW clinic types are displayed, all other clinic types have been grouped into “other clinic”.

ICB - sub group level

ICB - sub group level has been defined as the parent of the referring organisation. ICB – sub group organisations are as of 1 April 2022 and include the July 2022 ICB – sub group mergers.

The interactive dashboard which accompanies these open data files includes only data for ICB – sub group organisations. The open data files include referrals, bookings and appointment slot issues from both ICB – sub group and non-ICB – sub group organisations. Therefore, users of the open data files may wish to include or exclude data from the non-ICB – sub group organisations from their own analyses.

Only activity attributed to ICB - sub groups and other non-ICB - sub group organisations in England is included.  As the ICB - sub group is based on the postcode of the referring organisation, it is possible that patients are interacting with services in England but resident in other countries outside of England i.e. Scotland, Wales and the Channel Islands.

Reported measures

The number of events are the number of referrals, bookings or ASIs per week after adjustment for bank holidays. 

4-week rolling average is the mean number of referrals, bookings or ASIs per week for the last 4 consecutive weeks (rolling 4-week period), after adjustment for bank holidays.  

Referral rate is the number of initial referrals per 10,000 population (patients registered at a GP practice) per week, after adjustment for bank holidays.  

Bookings rate is the number of bookings per 10,000 population (patients registered at a GP practice) per week, after adjustment for bank holidays. 

ASI rate is the number of ASIs per 10,000 referrals (number of referrals in e-RS) per week, after adjustment for bank holidays.  

4-week rolling event rate is the mean number of events per 10,000 population per week for the last 4 consecutive weeks (rolling 4-week period), after adjustment for bank holidays. 

The percentage change is the percentage change in number of referrals, bookings or ASIs from the baseline. The baseline was defined as the average number of referrals, bookings or ASIs per week between 7 October and 29 December 2019. This period was chosen as it was unlikely to be affected by COVID-19.  

Covid-19 Impact

Due to the impact of Covid-19, several weeks data show a higher number of appointment slot issues than the number of referrals raised. This may be due to the cancellation of routine appointments, and the subsequent rebooking attempts made by patients.

The percentage of GPs referring patients to first outpatient services using e-RS, in England is high, typically 95% or more.

Feedback

The dataset will be updated monthly and feedback is welcome here:  [email protected]  Please reference “NHS e-RS Open Dataset feedback” in the title of the email.