Routine Referrals

The Introduction of our Electronic Referral System (e-RS)


This information sheet provides an update on the new Electronic Referral System (eRS). This system provides a real opportunity to improve process but also the patient experience. The following information provides an overview of what eRS is, the options available to refer patients, the benefits attached with this system and the support with key dates of importance going forward.


What is eRS

ERS is as the name states, an electronic referral system. The National “e-RS Paper Switch-off Programme” involves moving to full use of e-RS for all consultant-led first outpatient appointments, including Two Week Referrals. As a result from 1 October 2018 Providers under the terms of the National Contract will not be able to process (and will not be paid for any activity resulting from) referrals by GPs to Consultant-led acute outpatient services made other than through the NHS e-Referral Service.


Options Available To Refer Patients

There are a number of options available to refer via eRS. These are as follows:

  • Referrals sent to the RSS/RFS (for those CCGs using that functionality).
  • Referrals booked direct to the Trust by the GP or practice staff after discussion with the patient.
  • Referral request generated with patient choice discussion and given to the patient so that they can go away and book in their own time and after discussion with their employers and /or family, either online or via the national Appointment Line.



The eRS system provides a number of benefits for both patients and GPs. Patient choice is made much easier as both waiting times for first appointments and average RTT times are displayed within the system. This reduces DNAs and patient cancellations leading to reduced administration within the GP practice and an improved patient experience. The added control that the eRS system gives the patient leads to reduced anxiety and therefore fewer calls to the GP practice while the patient is waiting to hear about an appointment.

The patient’s journey can be monitored within the system from referral to first outpatient attendance; this also provides an audit trail within the system which can be reported on from the monthly extracts, as every action within the system is saved. There is the added value that letters cannot go missing as they will be saved within the system.

The eRS system also allows for two way communication between GPs and Trust clinicians via the Advice and Guidance (A&G) service within eRS, albeit the Trust regrets it will not be able to convert A&G requests into appointments. A new referral will be required until such times that contracts between the CCG and Provider change.


A GPs Own Perspective

Dr Chris Markwick uses the NHS e-Referral Service (e-RS) at Carmel Medical Practice in Darlington. His local hospital, County Durham and Darlington NHS Foundation Trust became one of the first to take only electronic referrals. His comments on using the system are as follows:

“eRS provides a quick and easy way to book appointments online for GPs, their staff and patients. Time from first consultation in primary care to first appointment in secondary care is reduced. You can compare waiting times from a variety of providers and offer patients an informed choice.

“eRS has enormous benefits for patients in terms of shortening their waiting time. It also allows you to compose and share a referral letter with the patient present, ensuring they are kept informed and understand what the referral is for and that it is accurate. This can also form the basis of your notes. eRS gives you the assurance of knowing when the patient’s appointment is going to be, which, if there is a long wait, allows you to plan any follow-up you might need before they are seen.”1


The top tips Dr Markwick suggests from his experience are as follows:

  • Book patients’ appointments with them. Patients love this, and it allows you to plan follow ups.
  • Agree a day to move to full use of e-RS and involve the whole practice team.
  • Explore what the barriers are to using e-RS at your practice. Typically, time is perceived as an issue, but you can use the technology to reduce the duplication of record keeping and referral writing.
  • Use the freed up secretarial time to manage other tasks to reduce work load, such as chasing up results.
  • Use cut and paste or a template which pulls content into a standard letter. Go on a touch type course to speed things up.



For NW Surrey GPs a number of measures have been put in place to provide support for GPs. These are as follows:

  • Training courses
  • The use of the RSS
  • Training updates for GPs who wish to make their own referrals and assist with patient making own referral.


Referrals must be sent via e referrals unless otherwise directed by your CCG. If you are unable to find the service on e referrals please contact us for advice on either or

Referrals should not be faxed as there are no longer any fax machines at the Trust.