Stage 1 - Design

Check if the NHS e-Referral Service fits your business needs and start your integration journey with us.

Before designing your software, you should get an overview of healthcare technology, integration and APIs by reading our introduction to healthcare technology.

You can get a broad understanding of referrals and bookings by reading our guide on building healthcare software.

During this step, you should make sure the e-Referral Service fits your business needs.

1.11 Independent Sector Healthcare Providers (ISHPs)

ISHPs or third sector providers should follow the guidance on how to make your services available through the e-RS. This is required for gaining authorisation to access NHS systems.

You must be able to describe the purpose and use case for which you are accessing the e-Referral Service.

This is so that we can check:

• you have justification for doing so
• the e-RS access method you need
• your required dataset
• whether an integration is possible for your use case

These guides describe the most common use cases and how to meet your business needs with an integrated solution.

Use these guides to confirm your use case, before starting development. If your use case is not included, please contact us.

You can find out what endpoints are available in our API catalogue and determine what functionality we offer.

These are outlined in Chapter 1.3 - Explore our FHIR API.

At this stage, you should:

• try our hands-on tutorials which teach you how to connect to our API
• access our open-access sandbox to learn and experiment
• have a general understanding of the API endpoints you want to integrate with

The e-Referral Service handles personally identifiable clinical data. It has strict controls on who can access it and how.

When using our API to access this data, there are security and authentication options which need to be considered.

These are outlined in Chapter 1.4 - Select your authorisation level.

Depending on your use case, you may require the use of other NHS services to create a functioning referral system:

1.51 Care Identity Service

The Care Identity Service (CIS) is the secure authentication service used by healthcare professionals to access national clinical systems.

Use CIS to authenticate your healthcare workers. This includes using smartcards or other authenticators like security keys, iPads and Windows Hello for Business.

If you are using the user-restricted access mode, you will require CIS2 Authentication.

You must onboard with the CIS team separately.

1.52 Personal Demographics Service

The Personal Demographics Service (PDS) is the national database of all NHS patients. It holds patient details such as name, address, date of birth and NHS number.

Use PDS to retrieve or synchronise a patient's demographic details.

The e-RS FHIR API only provides NHS numbers for patient identification purposes. The PDS FHIR API must be used to obtain additional personal data.

If your software involves creating referrals or advice and guidance requests, or carrying out clinical decisions, then you will require PDS.

You must onboard with the PDS team separately.

1.53 Spine Directory Service

The Spine Directory Service (SDS) is a national database of health and social care organisations, workers and IT systems.

Use SDS to access details of people, organisations and registered systems.

The e-RS FHIR API only provides the SDS user ID for healthcare workers. Use the SDS LDAP API or the Healthcare Worker (HCW) - FHIR API to obtain additional people data.

You must onboard with the LDAP or HCW teams separately.

There are some important standards and guidelines that your software must meet. This ensures that information can be shared securely and efficiently between systems.

There are described in Chapter 1.6 - Review our integration criteria.

You need to get your software approved by us before it can go live with our API - we call this onboarding. 

The onboarding process can sometimes be long, so it’s worth planning ahead. Read each of the five stages described on this website as this will help to ensure a smooth integration journey.

1.71 NHS e-Referral Service FHIR API - Onboarding video

Click the play button to watch a video which provides detailed information about the onboarding process.

The video lasts around 29 minutes and includes chapter markers.

1.72 Supplier Conformance Assessment List (SCAL)

We use the SCAL process for onboarding. The SCAL is used to declare and record how your product complies with a range of organisational, technical and compliance requirements.

It is recommended that the SCAL is reviewed sooner rather than later as it may affect the design of your software. We have provided the latest SCAL for this purpose.

You should not complete this SCAL.

We will provide you with a bespoke version when you are ready to commence building your product.

1.73 OpenAPI Specification (OAS)

We use the OAS, previously known as Swagger, to describe our API interface.

OAS is a global standard for describing RESTful APIs in a human and machine readable format.

The OAS file provides:

• an API overview, detailing the purpose and capabilities of the e-RS FHIR API
• technical documentation which includes authentication methods, request and response bodies and headers
• access and security information on how to gain access to the API

The purpose of this step is to start your integration journey with the API partner service.

We establish your contact details and describe how we will work with you. We will ensure you have all the support and documentation you need to proceed.

Let us know if you are working with other NHS APIs when you apply as there may be linked dependencies.

Get support on integrating with our API by checking out our developer community.

You can:

• search and find answers to your query
• post your own questions
• join a community of professionals with similar objectives