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NHS England injects £55m to boost e-Referrals uptake

NHS England will use £55m to reward GPs and hospitals using digital referrals by 2018 to increase uptake of its e-Referrals programme

NHS England will make £55m available in funding to clinical commissioning groups (CCGs) to reward GP practices using electronic referrals.

NHS England’s e-Referral service went live in June 2015, and around 50% of patients are referred for hospital appointments using the system. The centre has set a target of 60% of all patients being referred to hospitals electronically by September 2016. This will increase to 100% by 2018.

Together with NHS Improvement, the centre also plans to consult on a proposal making sure that, by 2018, NHS commissioners and providers are no longer paid for paper referrals.

NHS England will release up to £55m of funding through its Quality Premium 2016-17 scheme, designed to reward CCGs for improvement in quality of services. There will also be further payments for hospitals adopting electronic referrals through a 2017-18 Commissioning for Quality and Innovation (CQUIN), which gives providers recognition for improvement and excellence.

Duty of care

NHS England’s director of digital technology Beverley Bryant said the healthcare system has “been let down by outmoded systems” where patients are referred to hospital by paper letters.

“We have a duty of care that extends beyond providing effective treatments. We must also provide an effective patient experience that ensures patients feel reassured at a time when they are most vulnerable,” she said.

The launch of the e-Referral system was dogged by delays and performance problems, with the system having to be suspended for a short while just two days after going live. However, the system is now working without any issues.

The e-Referral service replaced the Choose and Book system first introduced in 2004. It allows patients referred by their GP for an outpatient appointment to choose the date, time and venue if several providers are available.

The Health and Social Care Information Centre (HSCIC) is currently working on upgrading the system, which was built in-house in partnership with BJSS, and making it easier to use for patients.

Modern online patient interaction

James Hawkins, HSCIC director of programmes, told Computer Weekly earlier in March 2016 that the aim is to change online patient interaction with the e-referral service through a “much more modern browser and more choice”.

“We want it to help patients by giving them as much information about the hospitals as possible,” he said.

“Whether it’s important for you to get an appointment on a specific day, with a specific consultant, somewhere that has good parking or on the right bus journey, patients should be able to filter down to their exact needs.”

CQC ratings for the hospitals will also be available. HSCIC is opening up the back-end application programming interfaces (APIs), both as a way of enabling people or companies with good ideas on how to develop the system further to take that forward, but also to get a better management of supply and demand.

Research from the National Audit Office shows that patients are 50% less likely to miss their appointment if they are able to choose the date themselves. Reducing did not attend (DNA) rates can save hospitals money and free up time for clinicians to see more patients.

“We want to know if an appointment is used, and if someone cancels we could make that available to someone else right away. It could really help reduce DNAs,” said Hawkins.

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