Referring a patient - NHS e-Referral Service

1. Open the drop-down list by selecting the 'Specialty' box and selecting the appropriate specialty.
2. A 'Clinic type' drop-down will display. Select the correct clinic type.
3. Select 'Search' (for locally commissioned and national, consultant-led services).

Speciality and clinic types video (duration 5 minutes) - this video explains how terms are used within e-RS and how referrers can use this field to search for suitable services. 

1. Select 'Search for a clinician' option under 'Step 2: Select service details' section.
2. Enter the surname of the clinician in the 'Last name' field on the 'Search for a clinician' screen.
3. Click on 'Search' option (or press 'Return') and the search results will display below the 'Search' option.
4. Select the appropriate clinician (or use the other search fields first, to refine your search and then choose 'Search' again).
5. When you return to the 'Search for a service' screen, the named clinician selected will display.
6. Select 'Search' (for locally commissioned and national, consultant-led services).

At the top of the screen, the ‘Show tasks for:’ information line will only be displayed to referring clinician users. Other referring users will not see these options. 

The ‘Show tasks for:’ radio button will be automatically defaulted to ‘Me’ on entering the worklist tab.

This means the referring clinician will see referrals in the worklists for which they are the referrer for the organisation they have logged in under.

Changing the radio button to show referrals for ‘My organisation’, will display the total number of referrals in the worklist for the organisation the user has logged in under.

On the worklist home screen, a referring clinician admin or referring admin user will see the total number of referrals for the organisation the user has logged in under. Users will notice that the ‘Show tasks for:’ information line isn't displayed.

Users will have six worklists tiles presented.

All worklists should be monitored regularly.

When you select a specific worklist, the worklist name is displayed at the top, with the total count of UBRNs shown in brackets.  

Any selected worklist screen displays a 'Show filters' option. Selecting 'Show filters' will display a filter pane on the left side of the screen. The options that will be shown in this filter area will be dependent on the referral information available in each worklist.

For example, if only ‘Routine’ and ‘2 Week Wait’ referrals are in the worklist results, then only these options will be available to be selected to filter on.

When filters are selected, these will be applied to the list automatically and will be retained whilst the user remains on the worklist.

The number of filters selected shows in brackets next to the 'Hide filters' option. Click on the 'Hide filters' option to hide the filters pane. This will allow further screen space to view the worklist information.

There is an option to ‘Clear’ filters which returns the user to the original data set.

The column headers can be sorted by selecting the arrows next to the heading titles.

Any sorting applied will be retained if the user moves to a different e-RS screen and then returns. For example, if the user actions a referral and returns to the worklist.

The 'Scroll' options display where not all the columns are displayed on a user's screen. This enables the user to move left and right as necessary to view remaining columns.

When you select a UBRN on the 'Active advice requests' worklist, the 'Advice summary' screen is displayed. UBRNs on all other worklists display 'Referral summary' screen. You can view the information on the advice or referral from the summary screens and perform any required actions. 

Notification badges

Worklist dashboard display 2 types of notification badges:

‘Unread’ badge – this shows the total number of UBRNs that have arrived on the worklist since the user last viewed it and where no action from the organisation has been taken. This badge will be displayed on the following worklists:

• Triage responses/Rejected referrals

• Incomplete UBRNs

• Active advice requests

• Assessment results/Cancelled referrals/Did not attends

When one of the above worklists is selected, the unread notification appears below the worklist heading and the number of unread notifications corresponds with the number of UBRNs in that worklist highlighted with a red dot.

Once the UBRN has been selected, either by the logged in user or by someone else in the same organisation, the count on the badge is updated and the red dot by the UBRN removed.

If the required action is taken, the UBRN will be removed from the worklist and the worklist count updated.

‘Overdue’ badge – this will appear on the ‘Missing referral letters’ worklist. When the worklist is selected, the badge will also display under the worklist name and next to any UBRNs for which the clinical information is overdue.

Routine referral letters should be attached within three days of the referral being created, one day for urgent and one day for two Week Wait.

If information is not attached after this time period, the ‘Overdue’ badge will be displayed.

Once a letter is added to a referral, it will be removed from the worklist and the count on the ‘Missing referral letters’ worklist tile updated.

If a referral is being actioned by a user within an organisation and another user attempts to open the summary screen to perform an action on the same UBRN, the second user (and any other subsequent users) from the organisation will receive a message similar to one below.

This message appears on screen until the first user to edit the referral has completed or abandoned their selected action. 

The 'Last updated' information shows above the worklist tiles on the worklists dashboard.

When a worklist is selected, the 'Last updated' information shows above the UBRN details on each selected worklist. 

When users select a referral to either perform an action, or review information, and then return to the worklist, the information will automatically be refreshed.

The blue ‘Refresh’ link can be selected to retrieve the latest worklist information at any time.

When a worklist is selected, you will notice an ‘Export to Excel’ option above the column headings. Use this option to export the information displayed on the worklist into an Excel format.

The example above shows how the worklist would look when exported into Excel. The information displayed is exactly what the user was viewing on the worklist. From here, the user can print or save the information.

The ‘Add/remove columns’ option displays above the column headings. Use this option to make selections of columns to hide or display . 

Things to note:

• the columns available to select are based on those displayed in the active worklist
• the columns not shown on this reveal are mandatory and cannot be removed (for example, UBRN, patient name, priority and status)
• to add or remove columns, select the required tick box and select ‘Save’
• any changes are saved permanently and remembered

This worklist shows referrals that have been returned to the referrer with advice and/or rejected by the service provider.

Status: Triage Response

Referral sent to a Referral Assessment Service (RAS) has been assessed by a service provider and sent back.

Review and action accordingly.

Information on this worklist and how to action referrals can also be reviewed on referral assessment services (RAS) webpage.

Status: Rejected

After the receiving clinician has assessed the referral information provided by the GP; it is felt that the patient could be managed more effectively either by an alternative, more clinically appropriate service or in primary care. The referrer must act upon these referrals. This may include cancelling the referral or identifying new, more suitable services.

View any comments made by the service provider and take clinically appropriate action from the options available. 

This worklist shows referrals that have been created but no referral letter has been attached. A referral letter can be attached either via the web-based e-RS system or an integrated GP clinical system.

Service providers will not be able to view and action the referral until a referral letter has been added.

In the image example above, there are 10 letters outstanding, with five of them being overdue.

Once the appropriate action is carried out, either by the logged in user or somebody else in the same organisation, the count will be updated.

The overdue label is automatically generated. For Routine referrals it is 3 days after the referral request is created, 1 day for Urgent and 1 day for two Week Wait.

UBRNs on this worklist are draft referrals which have had clinical information attached but have not been completed within the GP system.

Before the incomplete UBRNs can be processed you will need to ensure that a duplicate referral has not been created. This can be done in two ways:

1. Using the Patient tab, you can search by UBRN or patient's NHS number and access the Patient Activity. This will reveal all of the patient’s referrals and you can check for duplicate referrals.
2. Check for a duplicate referral within your GP software system – this can be used if the duplicate referral was initiated within the clinical system.

From both the Incomplete UBRNs worklist and Patient Activity list, a user can select the UBRN which will direct them to the Referral summary screen. There they will have the option to either cancel the request or select a service for patient's referral.

More information can also be reviewed from the Incomplete UBRNs page.

UBRNs on this worklist are for advice requests and responses. You can act by either replying to the response, ending the conversation, converting the response into a referral or remove the referral from the worklist (provider converted referrals only).

1. Select the UBRN.

2. Review the contents, which may include attachments.

3. If you need to continue the conversation you can type your reply into the 'Send new message' box and click 'Send message'. Use 'Select file' option to upload any additional information.

4. Where no further action is required, print the conversation, if required, using 'Download summary' option for the patient’s medical records and select 'End Conversation' from 'Select action' dropdown. For a referral that has been converted by a provider, select the 'Remove from worklist' button.

5. Where a referral is required you can select 'Create referral' from the 'Select action' dropdown.

More information for Active advice requests worklist can be found on the Advice and guidance for referrers page.

Referrals displayed on this worklist have had an assessment recorded against them, a UBRN cancelled, or a DNA recorded.

The worklist will show the status of the referral and any reason associated to the status.

View any comments made by the service provider and take clinically appropriate action from the options available.

Assessment Result

Referrals with this status have been sent to a service with Clinical Assessment Service (CAS) functionality.

Review and remove.

Cancelled referral

Referral requests, along with the patient’s appointment have been cancelled.

Check the reason why the referral request has been cancelled and remove it from the worklist.

Did not attend

If a patient was referred to a directly bookable service and they did not attend their appointment, the provider sends this back to notify the referrer.

View the referral and take the appropriate action, which may include re-submitting the referral request to the same (or a different) service.

This worklist shows referrals that have not been booked since shortlisting, or a referral that has been deferred to a provider, or a referral that has had an appointment cancelled and is awaiting booking by the provider or patient.

Booked referrals, whether to indirectly bookable services or directly bookable services, will not be presented on this worklist.