Steve Firman SRO NHS e-Referral Service, NHS England

1. Background & Context 2. Operationalising e-Referrals 3. Enhancing the service

1. Background & Context

Key Points: • The NHS e-Referral Service replaced Choose and Book in June 2015 • Service now stable

40,000 referrals per day 7 million bookings 50% utilisation

• Maintaining a stable service

• Developing the core application

• Operationalise use for 1st Outpatient Appointments

2. Operationalising e-Referrals

Three Year Package: • 2016/17 – CCG Quality Premium + GP Contract and Standard Contract• 2017/18 – CQUIN• 2018/19 – Aligning payment with use of NHS e-Referral Service

Three Year Trajectory Below:

60% September

2016

80% September

2017

Fully Operational September

2018

Programme Business Change Team - HSCIC

SRO function - NHS England

NHS Operational Teams - NHS England/NHS Improvement

3. Enhancing the service

• Widen scope of use

• Development of service as a referrals engine

• Enabling NHS transformation

• Exponential benefits to patients and NHS

Digitising elective care delivering a single referral and booking service for all elective care throughout the NHS and partner organisations.

Referrer

ERS

Appointment or Diagnostic

Follow-up

More Referrers• GP• Optometrists• Dentists• District Nurses• Midwives

More Services• Primary Care Services• Counselling Services• Community Services• Social Services• Private Services

Appointments Types• Follow-ups• Diagnostics• Urgent Care• Pre-op Assessment• Day Care

ERS

Developing key capabilities

Using Agile development

Integrating with other systems

Current Position Enhancements Transformation

• Inherent benefits of connecting clinicians electronically

• ‘Advice and Guidance’ (A&G) on ERS now but not widely used

Plans for improvements to A&G:• Multi-way Q&A conversations• Conversion of advice to

referral by providers• Alerts to GPs• Integrate ‘decision support’

tools • Pathway management

Interoperability

Don Berwick “move knowledge not people”• Specialists act as knowledge

experts • Patients not attending

hospital for many mild/moderate medical needs

• Savings to commissioners

New Ways of Working • Multi-disciplinary team• Distilling all past research and designs• Quick sketches• Show people – constant feedback• Prototyping

New Patient App • Supports shift to digital • Improved convenience and control for

patients• Cost savings over current model

Clear Choice

Hero Items

Options to:- Filter- Sort- Map

Delivering an integration capability to enhance benefits and improve user experience, supporting the NHS vision of achieving paperless referrals.

Stakeholder Engagement

Opportunity Analysis

Marketplace Innovation

Partnership Delivery

Benefits Realisation

• Progressive release of common and open APIs to enable information sharing

• Development of platform including security, assurance and information governance

• Plan to prioritise key capabilities e.g. • Service search, selection and booking in GP system • Referral letter automatically saved in PAS

1. NHS e-Referral Service – Operationalising e-Referrals

2. Digitising Elective Care – Enhancing the service

• We would like to LISTEN and receive FEEDBACK

• Input into NEW user requirements

• Contact the programme team at HSCIC www.hscic.gov.uk/referrals/contact • Contact Steve Firman – stephenfirman@nhs.net

How have you seen electronic referring change the way that you work and what would you wish of the future NHS e-Referral Service to help improve benefits going forward?Derek WallerConsultant Physician, Deputy Medical Director & Clinical IT Lead University Hospital Southampton NHS FT

Dr Karl Graham GP & Clinical Director IT West Hampshire CCG

A view on future of the service and how we will take these ideas forward. Dr Stephen MillerMedical DirectorNHS e-Referrals Service