Previewing and downloading files in the NHS e-Referral Service

To improve workflow efficiency, providers (October 2025 onwards) and referrers (date to be confirmed) will have a new feature which will allow them to preview and/or download files attached to referrals and advice requests within the NHS e-Referral Service (e-RS).

Changes for providers

December 2025 - Enhancements when viewing image files

Since this update, provider users accessing image files are able to preview these within e-RS and have the ability to navigate the image. For example, zoom in/out, pan and drag, fit-to-screen/reset zoom, rotate.

preview image showing navigational option

There is currently an issue stopping users from panning images upon opening the image preview. To enable panning, users must first select the 'Reset' option.

October 2025 Previewing and downloading files within e-RS

Providers are able to view files via a new ‘Preview’ option which displays the file within the e-RS screen and/or download files attached to referrals and advice requests.

appointment summary screen for converted advice and guidance request - referral with clinical information attached and download/preview options displayed

Previewing clinical attachments

The ‘Preview’ option is shown when the file type is supported by the user’s browser.

Supported file types

The following table details which file types which can and cannot be previewed by providers from e-RS - uploaded October 2025:

File type	File extensions	Preview supported
MSWORD (application/msword)	.doc	No
MSWORD (application/vnd.openxmlformats-officedocument.wordprocessingml.document)	.docx	No
RTF Text (text/rtf OR application/rtf)	.rtf .rtx	No
XML Text (text/xml OR application/xml)	.xml	Yes
Plain Text (text/plain)	.txt	Yes
PDF (application/pdf)	.pdf	Yes
PNG Image (image/png)	.png	Yes
GIF Image (image/gif)	.gif	Yes
JPEG Image (image/jpeg)	.jpg .jpe .jpeg	Yes
TIFF Image (image/tiff)	.tif .tiff	No
Basic Audio (audio/basic)	.au	No
MPEG audio layer 3 (audio/mpeg)	.mp3	Yes
MPEG Video (video/mpeg)	.mpg .mpeg .mpe	No
HTML Text (text/html) Only supported on download, not supported for upload by any method	html .htm	No

Selecting ‘Preview’ will open the file on screen. The file name and file contents will be shown and attachment description presented where available. A ‘Go back’ button will be displayed at the top left of the screen to return to the previous screen. The file can also be downloaded from this preview screen, if needed.

PDF file type opened in preview view

Downloading clinical attachments

A ‘Download’ link option is displayed under or next to the ‘Action’ field for referrals or advice requests.

Alt text: appointment summary screen with clinical information attached and download/preview options displayed In the example above, 'File name' column will be renamed 'File' with the clickable link to open the clinical information removed. Users will now access the documentation using the 'Download/Preview' options under the 'Action' column.

When selected, the clinical attachment is downloaded to the user's local device as it is currently.

Use of robotic software (RPAs) or ‘screen-scrapers’ to download e-RS attachments is not supported for use with the e-RS application as Application Programming Interfaces (APIs) are available that enable this automation. APIs are secure, robust and allow organisations to access e-RS functionality, or data, within their own integrated system. Organisations currently using RPAs should contact their relevant Patient Administration System (PAS) or Electronic Patient Record (EPR) supplier for more information.

Find out further information on e-RS APIs.

Last edited: 17 December 2025 11:43 am