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NHS e-Referral Service

The NHS e-Referral Service (e-RS) combines electronic booking with a choice of place, date and time for first hospital or clinic appointments. Patients can choose their initial hospital or clinic appointment, book it in the GP surgery at the point of referral, or later at home on the phone or online.

Live service information and alerts

Paper switch off - find out about the paper switch off programme, including switch off dates and implementation information.

Reports and statistics - including weekly utilisation reports

If you're a patient, book or manage your e-referral - visit NHS Choices if you've been referred to a hospital or clinic through the NHS e-Referral Service.

Paper switch off


The Standard Contract for 2018/19 requires the full use of the NHS e-Referral Service (eRS) for all consultant-led first outpatient appointments. From 1 October 2018, providers will only be paid for activity resulting from referrals made through eRS. This will support local health communities to plan for the paper switch off for elective referrals.

Find out the latest paper switch off (PSO) dates for NHS Trusts.

Resources to help you with paper switch off

Video case study

This case study shows how Yeovil District Hospital NHS Foundation Trust achieved paper switch off in November 2017. It highlights the trust's approach to paper switch off and their top tips.

Case study

Find out about a icon GP's view of e-RS [210.07KB] where the local trust has switched off paper referrals.

Implementation pack

The  icon paper switch off implementation pack [380.91KB] details the recommended approach to the project, from establishing project governance and set-up, to business process change, along with:

  • associated guidance
  • templates


Communicating your plans effectively has been highlighted as critical. Use this new icon communication toolkit [1.98MB] to help you to plan and deliver your communication activity. If you require further information, contact your NHS Digital Implementation Manager (details are in the implementation pack).

Find out more about paper switch off. 

Using the service

If you're a patient, find out more about appointment booking on the NHS Choices website.

Whether you're using e-RS for the first time, or an existing user wanting to make the most of the service, NHS Digital provides a range of material for referrers (such as a general practice), providers (a hospital or clinic) and commissioners.

This demonstration video shows a typical patient journey using e-RS:

This shows how to:

  • create a service
  • raise an Advice and Guidance request and receive responses
  • create a referral
  • a patient makes an appointment online
  • a provider accepts a referral

You can use this version to view specific parts of a typical patient journey (this requires Adobe Flash Player v10 or higher).

Benefits of the service

The benefits of e-RS include:

  • cost and time savings
  • fewer missed appointments
  • fewer inappropriate referrals
  • shorter referral to treatment times
  • choice of hospital or specialist
  • choice of appointment date and time

Find out more about the icon benefits of the service. [186.57KB]

Improving the service

We are continually improving the service and many changes have already been made, and more are planned. Find out how the service is improving..

More about the service

Case studies

Covering lessons learned and personal experiences, these case studies provide an insight into the implementation, benefits and use of the NHS e-Referral Service (e-RS) across primary and secondary care.


The NHS e-Referral Service (e-RS) is used to make around 40,000 referrals daily. A full record of these is available in the application, with a wealth of information that can be used when making commissioning decisions and managing referrals.

Contact us

If you're a referrer, provider or commissioner with a general enquiry about the NHS e-Referral Service (e-RS), please complete this form. This form is not for patient enquiries.

Deployment and utilisation progress data

We're responsible for recording data related to the deployment of systems and services across health and social care systems in England. On this page you'll find links to management information dashboards containing this data.

Document library

Download guidance and implementation documents for the NHS e-Referral Service.

e-Referral Service news and events

Keep up-to-date with e-Referral Service (e-RS) progress, news and events.


Find out how to integrate systems to enable electronic booking with the NHS e-Referral Service (e-RS), including how to achieve compliance, attain secure coupling and support safe business process interactions.

Live service information and alerts

Find out about NHS e-Referral Service (e-RS) planned maintenance and service availability.


Information and training for providers using the NHS e-Referral Service (e-RS), as well as guidance and help to make the most of the system. You can also learn about benefits and best practice.


Find information and training to help you get started with making referrals in the NHS e-Referral Service (e-RS), as well as guidance and help to make the most of the system.

Reports and statistics

These reports are intended to be used in addition to local NHS e-Referral Service reports and extracts available from within our application. Each report includes a cover page detailing the contents, and the criteria used for any data analysis.

The future of the NHS e-Referral Service

Thanks to user feedback, the NHS e-Referral Service (e-RS) is continually improving to make it easier, quicker and more convenient to use. Find out about the improvements we're making.

Have a question about the e-Referral Service? Please contact

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