Hospital referrals go 100% electronic for more than half a million patients

31 Aug 2018

An NHS trust in North East England has eliminated paper hospital referrals from GPs and gone 100% electronic– thanks to a joint initiative with NHS Digital that could save £50.5m a year if replicated across the health service*.

The news comes as NHS England announces that from October 1 this year, trusts will only be paid for outpatient appointments that are booked electronically.

Instead of waiting up to a month to get a letter with an outpatient appointment, all patients in County Durham can now go online and book an appointment, with instant confirmation of their slot. GPs are also able to access advice and guidance on treatment from consultants. It’s the result of a three-month campaign by NHS Digital and County Durham and Darlington NHS Foundation Trust to make paper referrals a thing of the past.

The e-referrals system means patients can choose to attend the nearest suitable hospital to work or home for their appointment. County Durham and Darlington NHS Foundation Trust manages eight local hospitals covering a population of 650,000. It receives 8,000 GP referrals a month.

GPs send e-referrals via the NHS’s electronic referrals service (e-RS) to the hospital’s patient administration system, CaMIS from EMIS Health. As well as processing outpatient appointments electronically, they can also ask consultants for advice and guidance on treatment before making a referral, to cut hospital appointments to a minimum.

Patient booking manager Margaret Herkes explained that NHS Digital asked the trust to push for the 100% target because it already had a high success rate in e-referrals, at 80%. The trust was an early adopter of e-RS ten years ago.

She said: “We liaised with local GPs to understand why they did not always refer through the e-RS. There were two main reasons. One was that not all hospital consultants were named on the e-RS, so they had to send a paper referral if they wanted a specific clinician. The other was that GPs could not refer through e-RS if they only wanted advice, not an appointment.

“We worked with EMIS Health to develop CaMIS so that the system could do this for us and a month later, 100% of e-referrals were electronic”

Margaret Herkes, patient booking manager, County Durham and Darlington NHS Foundation Trust

Ms Herkes added: “It has massively cut down on the time patients wait to hear about a hospital appointment, and it means clinicians’ time is used much more efficiently.”

Dr Nicola Murray from the local Clinical Commissioning Group said: “e-RS should be standard throughout the NHS. It is quicker, cheaper and safer than paper referrals, as it provides an audit trail and unique UBRN number in our worklists so that we can track patients. It means we do not have to spend time on the phone chasing referrals and advice. “

Ian Taylor, Chief Operating Officer at EMIS Health said: “EMIS Health was founded on the principle of working in partnership with clinicians to develop and improve our clinical systems. We were delighted to work with County Durham and Darlington NHS Foundation Trust to help further improve their already efficient e-RS and make life easier for clinicians and patients, as well as helping the trust to maximise its income from referrals.” 

*https://digital.nhs.uk/e-Referral-Service ‘Realising the benefits’