Part of Guide to creating referrals in the NHS e-Referral Service on the Path to Live environments
Arrange appointment (indirect booking)
These instructions cover the entry of mandatory information required to create a referral with an indirect appointment booking.
In this process, the provider can include their service on e-RS but lacks the functionality for a referrer to book an appointment directly. This is because the service is not linked to a Patient Administration System (PAS). The process relies on the patient contacting the service for an appointment. The appointment can then be entered manually into e-RS by the provider.
1. Find a patient
When you log in to the e-RS web application as a referring clinician (RC) or referring clinician admin (RCA) at a referring organisation, like a GP practice, it will default to the 'Patient' tab.
To start the referral process, you must find the patient using one of the three search methods:
- NHS number.
- UBRN (Unique Booking Reference Number).
- Patient details
Find the NHS number for one of your test patients and hit 'search' to retrieve the patient details.


2. Search for a service
The search for a service page will be displayed.
If you are logged in as an RCA, you will need to select the delegated clinician who are creating the referral on behalf of.

Select an appropriate:
- referral priority
- specialty
- clinic type
Ensure you select a priority, specialty and clinic type you have configured as part of creating services.
The patient being referred must match the criteria for your service. Check the age and sex of the patient being referred against the restrictions on the service. For example, if the service has been restricted to females over 65 years of age, creating a referral for a 4 year old boy will not return the required service in a search.
Select 'Search'.

Supporting service search information is available within the e-RS online help.
3. Referral service search results
The service search results will be displayed.
Search results can include:
- Bookable services, which can either be Directly Bookable (DBS) or Indirectly Bookable (IBS).
- Triage services, also known as Referral Assessment Service (RAS).
Find an IBS you have created and select it.
Select 'Book/Send for triage'.

4. Complete the referral
The review services page will be presented. This is an opportunity to check that all of the referral information is correct.
Click 'Create referral (patient to book)' to complete the process.

You will be informed that the referral has been created successfully.

5. Add referral letter
In most cases, the receiving service will require a referral letter (the clinical context), in order to review and accept the referral.
Attaching a referral letter can be done in several ways. In this step, we will be attaching a letter as part of the referral process.
From the 'Appointment request summary' screen, select 'Add referral letter'.
Select 'Add Attachment', and navigate to the file you would like to attach.
If required, repeat the step above to add multiple files up to a limit of 5MB each. There is no restriction on the number of files which can be added.
The e-RS supports a wide range of suitable file types.
Select 'Submit'.
6. Provide patient referral instructions
Referral instructions must be provided to the patient as part of this process.
The instructions inform the patient of their referral and includes:
- referral details (UBRN and access code)
- choice information
- how to choose a clinic
- assisted digital support
In this step, you can print the referral instructions to see what the document looks like.
On the referral summary screen, select 'Print patient appointment details'.
The letter will be previewed on-screen. From here, you can either print the document to a local printer, or save the document to a suitable location.
Click 'Close' to complete this referral journey.
7. Book appointment
To book an indirect appointment, you will be required to log in as a service provider at the receiving service.
Follow the steps outlined for providers of indirectly bookable services.
Last edited: 15 September 2025 5:01 pm