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).

It focuses on the steps providers need to take to review and update their e-RS DoS to include a revised set of specialties and clinic types. The changes to specialties and clinic types have been clinically reviewed and approved by GIRFT clinical colleagues and other national clinical leads.

Key activities and requirements summary

1. Providers must review all active services listed on their DoS including unpublished and end-dated services, to incorporate the new e-RS specialties and clinic types using the published list and mapping tool.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.  
2. Providers will 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 different changes can be found in this guidance. 
3. 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. 
4. 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.  

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 GIRFT clinical colleagues and other national clinical leads. Using this, providers must review all active services on the e-RS Directory of Services for their organisation.

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

Providers may also choose to review unpublished and end dated services. There are 3 possible options for each of these services: 

• delete the service if all patients have been managed and the service is no longer required 

• map the service to the new specialty and clinic type values 

• leave the service as is. After the new specialties and clinic types are introduced to e-RS, the service will need to be mapped to these before it can be made active again 

Phase 2 – Use the new ‘mapping tool’ 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 services

Currently, the mapping tool will also ask for an Advice and Guidance Alias if the service supports both advice and referral requests. This was to support an earlier requirement to split any such services, which has now been removed. The information is no longer required and will be taken out of the mapping tool in a later update. Providers can either enter information in this field, which will subsequently be deleted, or leave the field empty. Once the tool is updated to remove the Advice and Guidance Alias any services showing as ‘In Progress’ will update to ‘Completed’, if all other fields have been completed.

The information entered in the mapping tool will only take effect once the new specialties and clinic types are introduced for all users. 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 four 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, for example.

In this scenario, there are two 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. 

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 currently 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 two 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. 

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.

Previous versions of this guidance suggested splitting services that offer both A&G and referrals functionality (Bookable or RAS). This requirement has been removed. Further information on configuring e-RS services to support Single Points of Access will be made available at the earliest opportunity.