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NHS e-Referral Service: What is it and why does it matter?

Charlotte Jee | Aug. 17, 2015
The NHS e-Referral Service has been beset by glitches since it launched in June. A seemingly minor setback perhaps - but here's why we should be worried.

At first glance, the NHS system used by patients to book hospital appointments - the e-Referral Service - is just a small part of the complex IT picture within the health service.

However the NHS says it is a "vital" part of plans for a 'paperless NHS' by 2018, announced by Health Secretary Jeremy Hunt two years ago.

The service went live in June as a direct successor to the 'Choose and Book' system launched in 2005, part of the (otherwise generally disastrous) National Programme for IT.

It crashed after just two days and was introduced with 33 'known issues' including slow loading, glitches with functionality and problems displaying forms, NHS IT agency the Health and Social Care Information Centre admitted.

The system has since been taken fully offline several times, with more than two new software releases implemented aimed at fixing the functionality issues.

This is despite the fact launch was delayed for seven months in October 2014, a mere month before the system was supposed to go live, after it failed on 11 out of 26 criteria during a Government Digital Service assessment in July 2014.

In theory this was to give the team time to "carry out significant additional work." During that period they did a "huge amount of testing," according to HSCIC.

The lead supplier on the programme, BJSS, has been working on building the system since it won the contract in February 2012, but has refused - or perhaps been unable due to contract terms - to comment on the glitches.

Why do problems with the system matter?

In short, the NHS needs the e-Referral Service to work in order to become 'fully digitised', as Hunt promised back in 2013.

Choose and Book was used by about 40,000 patients every day to book hospital appointments online, although another 40,000 still chose to rely on paper-based referrals, NHS England's Technology Director Beverly Bryant said in July 2013.

The NHS hopes e-Referrals will encourage patients to book appointments online and better integrate with other parts of the health service, including GP and hospital systems.

The HSCIC says paper referrals are expensive, outdated and labour intensive.

They add to existing problems with long NHS waiting lists and there is plenty of evidence they put patients' lives at risk far more than electronic referrals-NHS Wales' Informatics Service estimates as many as 13,000 paper referrals go missing every year.

It is not mandatory to use the e-Referrals service, but the NHS hopes it will be so much more user-friendly than its predecessor that patients will opt to use it instead of paper to book appointments, allowing the entire referrals process to take place online.


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