Receive and review referrals as a service provider

This page describes the functionality available via the e-Referral Service (e-RS) API for service provider organisations to receive referrals, including all associated clinical referral information, and subsequently review those referrals.

This use case guide covers:

1. Retrieve clinical referral information.
2. Review referral.

The process diagram shows how the various endpoints can be used to create an integrated solution. Endpoints in red denote those which can be accessed via the application-restricted, unattended access route.

This use case covers the functionality to retrieve full details of a referral. 

This includes specific referral information:

• shortlist information
• referral priority
• specialty
• references to file attachments
• reference to an appointment (if booked)
• related referrals

1.1 Identify referrals

Endpoint: Retrieve referral worklist (A008)

The referral process starts with identifying all active referrals from a providers worklist.

Worklists provide lists of referrals that meet certain criteria, typically where a user needs to be aware of something important, or to undertake an action, in order to avoid delays to patient care.

Service provider worklists which are supported:

• Referrals for review (RFR)
• Appointment slot issues (ASI)

Referrals for review

The referrals for review worklist contains both triage referrals and those referrals with appointment bookings which require a review.

Appointment Slot Issues

This worklist contains referrals which the provider has received and need an appointment booking. This occurs when an appointment booking was not possible. Further information on what appointment slot issues are and how to manage them can be found in the appointment slot issues guide.

Note: Referrals could also be identified from other sources such as the daily EBSX02 extract or through an integrated Patient Administration System (PAS) for booked appointments.

1.2 Retrieve clinical referral information

Endpoints: Retrieve referral request (A005), Retrieve attachment (A042), Retrieve clinical information (A007)

Once the referral (UBRN) is known, or is already known from another business process, then all three endpoints must be used to obtain the full scope of clinical referral information.

These endpoints are also available as Application-restricted, unattended access and detailed as part of our security and authorisation options.

Read the guidance on how to ensure your integrated software retrieves all the associated clinical referral information.

Once all clinically relevant information has been retrieved, further functionality can be used via the API to carry out a clinical review. The review process will differ depending on which type of referral is being assessed.

Your software solution will be required to have access to the Patient Demographic Service (PDS). This is to ensure a PDS trace has taken place which verifies the patient and their details, which could be used in later stages of the referral workflow. For example, a PDS check ensures that a patient is not deceased. To avoid any communications like letters from being sent.

2.1 Reviewing a booked referral

Endpoints: Accept referral (A013), Reject referral (A014), Upload file to document store (A020), Cancel appointment, action later (A022)

Once a referring organisation has booked an appointment and appropriate referral information has been added, the referral is available for the service provider to review. As part of this review process, a provider can choose to accept or reject the referral.

Accept referral

If the referral meets all the criteria for treatment at the selected service, then the provider can select to accept the referral into their service.

Reject referral

If the service provider feels the referral is inappropriate for their service, or they require additional referral information to make a decision, they can select to reject the referral. 

A rejection goes back to the referring organisation and places the referral on a worklist for the referrer to action.

Task an admin user to rebook or redirect a referral

An additional review option provides the ability to task an admin team to rebook or redirect a referral that is booked into a bookable service and awaiting review.

This action cancels the associated appointment.

It also places the referral on a provider's Appointment for Booking worklist for an admin user to action.

As part of this review step, it is possible to include attachments with the admin task. The Upload file to document store (A020) endpoint must be used to upload attachments, ready to be associated when the review action endpoint is called.

2.2 Reviewing a triage referral

Endpoints: Available actions for user list (A029), Record triage outcome (A028), Upload file to document store (A020)

A triage outcome can be recorded for referrals awaiting review:

• referrals sent into a triage service (RAS)
• referrals deferred into a directly bookable service because of appointment slot unavailability, i.e. those on the Appointment Slot Issue (ASI) worklist 

It is advisable to check ahead of performing a triage outcome, whether or not the action is permitted via the Available actions for user list (A029) endpoint.

As part of this review step, it is possible to include attachments with the outcome action. The Upload file to document store (A020) endpoint must be used to upload attachments, ready to be associated when the review outcome endpoint is called.