Booking and Referral Standard

A patient journey - from the patient presenting with symptoms, to appropriate treatment then discharge - often involves two or more NHS services. Booking, clinical and administrative information need to follow the patient at all stages of this journey. This frequently requires paper processes and multiple healthcare IT systems which can be inefficient.

The BaRS ensures healthcare professionals receive the information they need, in a format they can use, integrated into their existing healthcare IT systems.

The BaRS is a crucial part of digital transformation policy across the NHS. For example, the Government's Plan for Digital Health and Social Care states:

We are:

• building the necessary national infrastructure and components that will underpin delivery of BaRS
• providing an interoperability standard that allows multiple systems to communicate with each other in a simple and logical way
• publishing a standard that supports the administrative task of booking a patient into their next care setting, as well as providing the correct and relevant clinical referral information to care givers so that they can make or accept a patient referral
• producing a standard that is accepted, agreed and adopted by health care system providers and rolled out across the health system to improve patient experience and care outcomes

BaRS consists of documentation and guidance intended for use by organisations developing software solutions that must conform to the BaRS. This is supported by a routing proxy service (BaRS API). 

Solutions that conform to the BaRS enable digital patient journeys or operational workflows. This functionality will be available to users in a variety of systems, for example;

• an EPR (including GP and pharmacy systems) 
• a 111 system
• NHS App

BaRS can only be used in systems that have been assured for use by NHS England. You can view the progress of software development organisations in implementing BaRS on our supplier status page.

BaRS is available for the following patient journeys:

• between NHS 111/ clinical assessment services (CAS) and emergency departments (EDs, but also known as A&E, urgent treatment centres (UTC), same day emergency care (SDEC)
• between NHS 111 Online and EDs, UTCs 
• between Streaming and Redirection and EDs, UTCs
• between 999 and CAS for referral
• between 999 and CAS for ambulance validation 
• between GP and Community Pharmacy (beta)

Several patient journeys are currently in development or testing. These are journeys:

• between 999 AST and 999 AST (pre-release/beta)

There are many more journeys on the roadmap for BaRS over the next 12-24 months.

You can monitor supplier progress in implementing BaRS on our supplier status page.

The Data Alliance Partnership Board (DAPB) has approved the BaRS as an Information Standard.  A corresponding Information Standards Notice, reference DAPB4060 has been issued to support adoption and use of the Standard. All healthcare IT systems suppliers delivering systems to healthcare providers in applicable care settings must work with their customers to determine any necessary changes.

Information standard notice (ISN) conformance dates

There is no single conformance date for the BaRS Standard across NHS care settings as the scope of the standard will expand over time. NHS England will identify appropriate conformance dates as BaRS is developed for each new patient journey.

Implementing BaRS provides benefits to professionals across the healthcare sector.

Patients can:

• efficiently book appointments and time slots with the service that's right for them
• get the right advice and treatment when they most need it, safely and easily

Healthcare workers can

• receive the information they require, and in sufficient detail, to enable them to undertake the patient care activity requested
• triage the patient without asking them to unnecessarily repeat information already collected earlier in their journey
• send and receive booking and referral data that is integrated into existing healthcare IT systems - this avoids working across 2 or more applications or systems and saves time

IT suppliers and care providers should find it easier and more efficient to implement a single, agreed national interoperability standard, rather than supporting the multiple and varied standards currently in operation.

Commissioners and integrated care systems are able to easily integrate care journeys across care settings using existing systems.

A government report has acknowledged the work already done in this area and the benefits of sharing booking and referral data between healthcare IT systems and across care settings:

BaRS consists of:

• BaRS Core - the foundation of the standard containing all the things everyone has to do regardless of where BaRS is being used 
• BaRS Applications - which apply the standard to a specific problem and build on this to support specific use cases, for example between NHS 111/CAS and urgent treatment centres (UTC) 

BaRS Core includes the API Routing Proxy which is live. Each BaRS Application has a separate service status. Information about the status of BaRS applications, including pre-releases is available in the BaRS implementation guide. 

You can monitor software development organisation progress in implementing BaRS on our supplier status page.

The central BaRS routing proxy is a platinum service which means it is supported 24 hours a day, 365 days a year.

We're working on our roadmap.