Mergers and migrations of GP surgeries within the NHS e-Referral Service

GP surgeries can act as both referrer and service provider within NHS e-Referral Service (e-RS), both of which roles require specific actions when dealing with the merging of GP surgeries, or the transfer of a GP surgery to different organisation within the Spine Directory Service (SDS).

This page provides guidance for dealing with GP surgeries in their role as an e-RS referrer.

Find out more about dealing with transfer of services where a GP surgery acts as a service provider.

The process of migration/merging of GP surgeries within e-RS is essentially a manual one, with no automated transfer of referrals available. This is due partly due to the infrequent occurrence of GP re-organisations, and the simple manual procedures required to handle these occurrences.

The high-level process within e-RS for handling GP practice re-organisations is as follows.

1. Set up e-RS users with business functions in their target GP practice organisation, whilst retaining the existing roles and functions for their current GP practice.
2. If the new GP practice is a new organisation within SDS, and an integrated GP system is to be used, then relevant Organisation Data Service (ODS) codes and Spine messaging end-points should be defined as part of the re-organisation.
3. Once the GP practice re-organisation has taken place (including any GP system migration) the users should use their new roles for all new referrals (either directly in e-RS or via an integrated GP system).
4. Users should log onto e-RS via the roles under their old GP practice and manage the worklists for their old GP practice down. No new referrals should be created under these user roles.
5. Any referrals created under the old GP practice will require manual upload of referral letters. For this reason it may be advantageous to defer creation of referrals for a few days prior to GP re-organisation to avoid having to manually attach referral letters in e-RS.
6. Once worklists for referrals created by the old practice have been completed and remained at 0 items for 1 month (to allow any “Did Not Attend” messages to be sent from patient administration systems and processed) then user roles related to the old practice can be removed and the old practice code switched off in SDS.

The following images show a simulated process which a GP practice may take in completing outstanding worklist items.

The image below shows the worklists with outstanding items.

Immediately following a re-organisation all worklists have items for attention of the GP surgery.

The image below shows the worklists partially cleared.

At this stage all referral letters have been completed, and advice and guidance requests and rejected referrals have been dealt with and no more are being created at this practice. There are still outstanding appointments to be booked and attended by patients within the 'Referrals pending external action' worklist.

The image below shows all worklists cleared of referrals. 

At this stage all appointments have been attended by patients. There is still an opportunity for a Patient Administration System to send a “Did not Attend” message to e-RS, so it is recommended to wait 1 month after the last patient appointment before closing down all roles and the old GP practice code on SDS.