How the Patient Care Aggregator works

Patients can access their referrals and bookings with secondary care providers using the NHS App. They can view their referral and booking details and, in some cases, amend or cancel their bookings. 

Under the covers, the NHS App uses the Patient Care Aggregator to get the details from the secondary care booking systems, sometimes referred to as ‘patient portals’. 

Here’s how it works: 

1. A patient uses the NHS App to request a summary of their referrals and bookings.

2. The NHS App asks the Patient Care Aggregator for a summary of all referrals and bookings for the patient, based on their NHS number (API 1).

3. The Patient Care Aggregator asks the NHS e-Referral Service (e-RS) for a summary of any referrals and bookings that it knows about (API 2).

4. The Patient Care Aggregator asks the various secondary care booking systems for a summary of any bookings that they know about (API 3).

5. The Patient Care Aggregator returns all the summaries to the NHS App as a single list.

6. The NHS App displays the summary list to the patient.

7. If the patient wants more details for a particular referral or booking, they select a hyperlink in the NHS App.

8. The hyperlink takes them to a ‘patient portal’ - an NHS-styled, standardised web application within the secondary care booking system (or e-RS) that shows them the details for the booking.

9. In some cases, the patient can amend or cancel their booking via the portal web application.

10. To reduce network chatter, secondary care booking systems tell the Patient Care Aggregator which patients they know about in advance – that way the Patient Care Aggregator only has to ask for booking summaries from the relevant booking systems (API 4).

All systems use the NHS number to uniquely identify the patient. 

To make things secure, the NHS App and the portals use NHS login to authenticate the patient. The patient gets an NHS login account when they first register for the NHS App, and because NHS login is a single sign-on (SSO) system, the patient does not have to sign in directly to each portal because they are already signed in to the NHS App.

As well as bookings, some secondary care booking systems provide details of:

• documents - such as letters written by a consultant
• questionnaires - pre-appointment surveys completed by the patient

If any actionable documents or questionnaires exist, the Patient Care Aggregator returns an 'actionable items' flag to the NHS App. The patient cannot action these items directly in the NHS App. Rather, they need to follow the hyperlink to the associated patient portal to complete any actions.

Some secondary care booking systems send the patient notifications when certain events occur, such as:

• changes in appointment time or date
• cancellations
• reminder to complete questionnaires
• new documents available

The notifications might be:

• NHS App in-app messages
• native Apple or Android push notifications

The end-to-end service includes the following APIs:

See the Patient Care Aggregator service page for details.

At the moment, the patient-facing Patient Care Aggregator API can only be used by our own NHS App.