Guidance to support the e-Referral Service Directory of Services review

This guidance is for all NHS and independent sector providers who provide services on the NHS e-Referral Service (e-RS) Directory of Services (DoS) to receive referrals and Advice & Guidance (A&G). 

While it sets out the expected end state for a new service naming structure, it primarily focuses on the steps providers need to take to review and update e-RS DoS to include a revised set of specialties and clinic types. This is in readiness for the new national service naming convention to be introduced in 2026. The changes to specialties and clinic types are clinically reviewed and approved by Getting It Right First Team (GIRFT) clinical colleagues and other national clinical leads. 

Key activities and requirements summary

Providers must review all services listed on their DoS, including unpublished and end-dated services, to incorporate the new e-RS specialties and clinic types using the published list and mapping tool. The review and implementation of changes must be clinically led and signed off by an appropriate clinician and service manager. 

e-RS will be updated to include a new mapping tool which will allow Service Definers within providers to map each e-RS service to the finalised list of specialities and clinic types.

Providers need to consider whether to merge, split, close, or create new e-RS services on their DoS to align with the new specialities and clinic types. Further details and scenarios for changes can be found in this guidance.

For providers using directly bookable services (DBS), it may be necessary to review and update Patient Administration System (PAS) clinic mappings if the review leads to the creation or closure of any services.

Where providers currently use the e-RS service name to bring things to the attention of referrers or patients (for example, 'internal use only', 'do not attend'), they need to consider the impact of the new naming convention and reconfigure their services accordingly. Several examples are given at the end of this guidance.

Providers will need to ensure that services are correctly listed with regards to Legal Right to Choice. All services to which the right applies must have at least one Named Consultant associated to them.

In addition, to support the Single Points of Access (SPoA) model, being introduced later in 2026, services that offer Advice and Guidance will need to have at least once Named Consultant associated to them.

Where services offer Advice and Guidance functionality alongside referrals (Bookable or Referral Assessment Services), providers may wish to consider separating these in preparation for SPoA. Where services have not been separated, an automated process will run to do this when the new specialties and clinic types are introduced.

The introduction of the new e-RS service naming convention is designed to provide greater clarity and consistency for both referrers and patients when choosing services via e-RS. The new, automatically generated, service name will replace the current free text e-RS service name and will be constructed from several key data items to ensure that the displayed name is clear, standardised, and easily understood. The new naming convention does not allow for any elements of free text to be included for referrers or patients. The existing free text service name will be retained as an 'Alias' to help providers to manage their DoS.

Key features of the new naming convention for referrers and patients

The new service name will be automatically generated using a standardised format, based on the search terms used by the professional user, and will display in a variant of the following format:

Clinic Type – Specialty – Provider Name

Other relevant information, such as service type and service location will continue to be visible to referrers and for patients online via Manage Your Referral, via the NHS App or via patient printouts.  

Examples of how the new service naming convention will be displayed

When a referrer searches for services matching the Asthma clinic type within the Respiratory Medicine specialty, a service with only one clinic type associated to it (that is, Asthma) will appear as:

Asthma – Respiratory Medicine – [Provider Name]

However, if there is more than one clinic type associated to the service, the clinic type section of the service name will include 'General Clinic'. 

Continuing from the example above, a service with multiple clinic types associated to it will appear as:

Asthma (General Clinic) – Respiratory Medicine – [Provider Name]

If the service was also mapped to the Tuberculosis clinic type, an alternative name for the same service, when searched for using that clinic type, would be:

Tuberculosis (General Clinic) – Respiratory Medicine – [Provider Name]

There are some circumstances when a variation of the service name will be presented. For example, when a service has been searched for using a named consultant but without any specialty and clinic type information. In this case, the service name will either be presented as:

Clinic Type – Specialty – Provider Name (if the service has a single clinic type), or General Clinic – Specialty – Provider Name (if the service has multiple clinic types)

This approach ensures that service names are both meaningful and comparable. This will support referrers in identifying the most appropriate service for their patients. It will also give patients a clear understanding of the service to which they have been referred to and support them in choosing from a shortlist of services given to them by their referrer. 

Key features of the new naming convention for service providers

The new e-RS service naming convention also allows service providers to distinguish between closely aligned or similar services within their Directory of Services (DoS). This will help provider staff manage e-RS referrals, such as onward referring a patient to another service within their own organisation. 

Providers will retain the existing service name, which will become known as the 'Alias'. This will become a mandatory field once all DoS changes are applied.

This field will be for internal use only and will not be visible to referrers or patients. In most scenarios for example, worklists or enquiries, a provider user will be presented with the Alias name for their own services.

Within a provider’s DoS, alongside the Alias, each service will display a more detailed naming structure, including the following data items:   

Service ID – Request Type – Clinic Type/General Clinic – Specialty – Appointment Type – Location – Provider Name 

This enables providers to differentiate between services on their DoS.

This section supports service providers to plan resources and activities to ensure their organisation is ready for the implementation of the new specialties and clinic types and subsequent introduction of the new e-RS service naming convention.

Phase 1 – Reviewing existing services and mapping to new specialties and clinic types

A finalised list of new e-RS specialties and clinic types has been clinically reviewed and approved by Getting it Right First Time (GIRFT) clinical colleagues and other national clinical leads. Using this, providers must review all services on the e-RS Directory of Services for their organisation – this includes unpublished, and end dated services. 

It is recommended that this review commences as soon as the new specialty and clinic type list is released and prior to the e-RS mapping tool being made available for Service Definers (see Phase 2 below). Local records will need to be maintained, ready for entry onto e-RS.

To support this work, a report listing all e-RS services with their current specialties and clinic type(s) will be made available on the e-RS NHS Futures page (login required).

Service reviews must involve and be signed off by an appropriate clinician and service manager.

Phase 2 – Use the new ‘mapping tool’ which will be available via the e-RS Service Definer login

Using the e-RS mapping tool, which will be added to the e-RS Service Definer screens, Providers must confirm the following for their existing e-RS services:

New Specialty and Clinic Type(s) mapping.

Named Consultant(s) for any choice and Advice and Guidance services.

Service age range.

if providers do not chose to separate A&G from referral services at this stage, record an additional alias for the new A&G service that will be created automatically when the specialty and clinic type changes are applied.

The changes have appropriate clinical and managerial sign off.

The date that the mapping tool will be introduced will be notified to providers and service definers in advance. Providers should expect to have an 8-week period to complete this work, once the tool has been released. 

If a Service Definer wants changes to apply to services with immediate effect, they should record these using the existing 'All services' option. This includes creating new service or closing or deleting services that are no longer needed. Any changes made this way will be reflected in the mapping tool.

Phase 3 – Go Live of new specialties, clinic types and service names

At the point that the new specialties and clinic types are made available for referrers to search for services in e-RS, all the information captured in the mapping tool will be applied to services - no intervention will be needed by Service Definers. Service IDs and PAS clinic appointment mappings for existing services will be unchanged. Existing referrals and advice requests will be unaffected.

As described in phase 1 above, when reviewing services against the new specialty and clinic type list there are 4 possible scenarios to consider:

Scenario 1

The service can be mapped directly to a specialty and clinic type(s) in the new list. The mapping to the new specialty and clinic types should be noted in readiness for entry on e-RS. 

Scenario 2

The service needs to be split into multiple services. An example of this might be a service that is currently mapped to the e-RS Specialty of 'GI & Liver (Medicine and Surgery)' covering several of the current clinic types. With the new options this may need to be split into separate services in the specialties of Gastroenterology and Upper GI Surgery.

In this scenario, there are 2 options available.

Option 1

Retain the existing service as one of the new services needed and note the mapping to the new options.

Create the additional services that are required. Copying the existing service may be the simplest way to achieve this. Any newly created services will have to be set up using existing specialties and clinic types, so note the required mapping to the new options.

If these new services are not going live with immediate effect, they should be set to start on the date that the new specialties and clinic types go live for referrers to search against. 

This date may not be known when the services are created and will need to be updated later. Service Definers will be advised of the go live date via an e-RS notification and other communications.

Option 2

Have new services only and do not retain the existing service. For the existing service, a service transition date will need to be applied to coincide with the date that the new specialties and clinic types go live. 

This date may not be known when the service is reviewed and will need to be updated later, along with an appropriate service end date. Service Definers will be advised of the go live date via an e-RS notification and other communications.

Create the additional services that are required. Copying the existing service may be the simplest way to achieve this. Any newly created services will have to be set up using existing specialties and clinic types, so note the required mapping to the new options. 

If these new services are not going live with immediate effect, they should be set to start on the date that the new specialties and clinic types go live for referrers to search against. 

This date may not be known when the services are created and will need to be updated later. Service Definers will be advised of the go live date via an e-RS notification and other communications.

Creating new services

When creating any new services, it will be necessary to review the following sections of the DoS:

Notes for referrers.

Users.

Suitability guidance.

Patient appointment instructions (bookable services).

If a new service is not subject to the legal right to choice it will need to be commissioned on e-RS by the relevant organisation, for example, integrated care board (ICB), Ministry of Defence, Department of Health and Social Care or Ministry of Justice.

If a new service is directly bookable the provider will also need to carry out the appropriate work to map it to PAS clinic templates.

Scenario 3

The service can be merged with other services. For example, oncology services exist across several specialties in e-RS as no oncology specialty is currently available. The new list includes both Clinical Oncology and Medical Oncology as new specialities, which allows existing e-RS services to be rationalised.

In this scenario, there are 2 options available.

Option 1

Retain one or more of the existing services as it will be appropriate once the changes are applied and note the mapping to the new speciality and clinic type options.  

Close all the other services once the changes are applied. A service transition date will need to be recorded to coincide with the date that the new specialties and clinic types go live for referrers to search against. 

This date may not be known when the service is reviewed and will need to be updated later, along with an appropriate service end date. Service Definers will be advised of the go live date via an e-RS notification and other communications.

Option 2

Have new services only and do not retain the existing service. For the existing services, a service transition date will need to be applied to coincide with the date that the new specialties and clinic types go live. 

This date may not be known when the service is reviewed and will need to be updated later, along with an appropriate service end date. Service Definers will be advised of the go live date via an e-RS notification and other communications.

Create the additional services that are required. Copying the existing service may be the simplest way to achieve this. Any newly created services will have to be set up using existing specialties and clinic types, so note the required mapping to the new options. 

If these new services are not going live with immediate effect, they should be set to start on the date that the new specialties and clinic types go live for referrers to search against. 

This date may not be known when the services are created and will need to be updated later. Service Definers will be advised of the go live date via an e-RS notification and other communications.

Close all the other services once the changes are applied. A service transition date will need to be recorded to coincide with the date that the new specialties and clinic types go live for referrers to search against. 

This date may not be known when the service is reviewed and will need to be updated later, along with an appropriate service end date. Service Definers will be advised of the go live date via an e-RS notification and other communications.

Creating new services

When creating any new services, it will be necessary to review the following sections of the DoS:

Notes for referrers.

Users.

Suitability guidance.

Patient instructions (bookable services). 

If a new service is not subject to the legal right to choice it will need to be commissioned on e-RS by the relevant organisation, for example, integrated care board (ICB), Ministry of Defence, Department of Health and Social Care or Ministry of Justice.

If a new service is directly bookable the provider will also need to carry out the appropriate work to map it to clinic templates.

Scenario 4

The service is no longer required. For example, many Providers have unpublished services and services with a historic end date. If these services will not be needed in the future the Service Definer should delete these services, removing the need to complete the remapping exercise. Take care to ensure that the correct services are deleted.

Any active services that will not be needed should be transitioned and closed in the usual way and only deleted when safe to do so. These may need to be included in the remapping exercise.

Ensure that all services are correctly listed with regards to Legal Right to Choice. More information about the right to choice can be found on our website.

All services to which the right applies must have at least one Named Consultant associated with them in the 'Users' section of the Directory of Services. This may involve your Registration Authority team ensuring that the consultants have been set up with Service Provider Clinician access to e-RS. Named consultants must also be associated with services that accept Advice and Guidance requests, in readiness for the introduction of Single Points of Access.

Where services offer Advice and Guidance functionality alongside referrals (Bookable or RAS), providers should consider separating these in preparation for the introduction of Single Points of Access (SPoA) later in 2026.

When enabled, SPoA will use the A&G functionality in e-RS, referral services will not be visible to primary care referrers where a provider has a SPoA for a particular specialty or sub-specialty. This means that all Advice and Guidance services will need to be decoupled where they are not already standalone. Separate guidance will detail the full considerations for providers service setup as they move to SPoA, but separating A&G services is an important first step.

At the point that the new specialties and clinic types are introduced to e-RS any services that offer both A&G and referral functionality will be separated. With their future SPoA set up in mind, providers may prefer to review their current A&G configuration and manage the separation of their services manually. 

To separate services out the existing service should be copied (with an appropriate name given to the new service). 'Advice' must be removed from the 'Supported Request Types' of the existing service, and the service name should be updated to remove references to Advice and Guidance. The new (copied) service should be set up to only support advice and published. Any existing A&G requests will continue to be managed using the original service, with new requests being managed by the new service. The standard information will need to be entered into the mapping tool for any of these newly created services.

Where providers chose to use the automated process an 'A&G Alias' will need to be recorded as part of the mapping process. The automated process will then effectively carry out the same steps as described above, with the A&G Alias being applied as the Alias for the new service (the referral service is retained with the current name becoming its Alias. This will need to be reviewed to remove references to A&G once the changes have been applied).

In some cases, providers currently add additional free text to e-RS service names that will not be visible to referrers and patients once the new service naming convention is live. The examples below are not exhaustive, and we are not able to provide definitive guidance for providers in all scenarios. The list below includes examples of free-text elements within existing service names and suggestions for mitigating the impact of moving to the new service naming convention.