How to generate NHS e-referrals (e-rs) from EMIS Web The NHS electronic Referral Service (e-rs), formerly Choose and Book, combines electronic booking with a choice of place, date and time for first hospital or clinic appointments. e-rs is a national system and all first outpatient referrals are expected to be made via e- RS by October 2018. This step by step guide is aimed at clinical and non-clinical staff that have been delegated responsibility for using the NHS electronic Referral Service, (formerly Choose and Book) to refer patients. It includes information on: 1. Initiating an e-rs from EMIS Web 2. Searching for an Service on e-rs 3. Booking the patient s appointment on e-rs 4. Generating an appointment request for the patient 5. Attaching the clinical referral information to the UBRN (Unique Booking Reference Number) 6. How to attach the clinical referral letter later or additional information to the letter If you have any queries using this document, please contact your local GP IT Facilitator. For instructions on how to process a two week wait referral, please see the Step by Step Guide On How To Do A 2WW Referral Using DXS and ers Sept 17 v1 guide produced by Lambeth CCG. Blue boxes outline the actions that need to be undertaken at each stage. Red boxes highlight the buttons you need to click at each stage. Pre-requisites before generating a referral via e-rs The user must have an NHS smartcard with the correct access roles inserted in the card reader and synchronised with EMIS; Patient being referred must have an NHS number; and If generating the referral from EMIS, the patient s PDS (personal demographic services) needs to be synchronised with the national Spine. Accessing NHS electronic Referral Service (e-rs) e-rs interfaces with EMIS Web directly, but can also be accessed from your desktop at https://nww.ebs.ncrs.nhs.uk/app-ebs. e-rs can be accessed from EMIS Web by Clicking on the EMIS menu, External Links and then click on NHS e-referral Service; Adding an e-rs short cut to the EMIS toolbar; Accessing from the patients consultation or patient s profile, under referral (in the left-hand pane). This document is one in the series of e-rs training resources produced by the south London Facilitators (GPIT, NELCSU). Please refer to How to refer from EMIS via e-rs, How 7_How_to_ERS-screenshots_v0.1 www.nelcsu.nhs.uk
Step 1: Initiating an e-rs from EMIS Web Within EMIS Web, ensure the correct patient is selected that you wish to make a referral for. You can then generate an e-rs referral either: a) Within a consultation (preferred method) Click Referral Hover over NHS e-referral Select the appropriate priority (i.e. Routine, Urgent or 2 Week Rule) Note: If delegated to administrative staff, they will need to select the referrer s name to proceed. b) Within a patients profile Click Add (drop down arrow) Click Referral Hover over NHS e-referral Select the appropriate priority (i.e. Routine, Urgent or 2 Week Rule) Note: If delegated to administrative staff, they will need to select the referrer s name to proceed. NHS e-referral Service is launched within EMIS, displaying the Service Search Criteria screen. 7_How_to_ERS-screenshots_v0.1 www.nelcsu.nhs.uk 2
Step 2: Searching for a Service on e-rs Note: A Unique Booking Reference Number (UBRN) is created (displayed at the bottom of the screen), but not yet completed in e-rs. EMIS is frozen in the background. You must complete the whole referral process to ensure the e-rs is created correctly. Note: There are three ways to search for a Service o Clinical term (based on SNOMED CT terms); o Speciality and clinic type; and o Named clinician (this is reliant on the Trusts adding consultant names on e-rs) Check that the right Priority is selected (i.e. Routine, Urgent, 2 Week Rule) Select the appropriate Specialty from the drop down box Select the appropriate Clinic Type Click Search All Note: For assessment service (i.e. MCATS / Antenatal), select Search Primary Care. 7_How_to_ERS-screenshots_v0.1 www.nelcsu.nhs.uk 3
A list of providers and clinics will appear Select the provider/s the patient wishes to be seen at Regardless of whether you book the patient s appointment or generate an appointment request, you will need to attach the clinical referral information to the UBRN, which is explained in Step 5. After you have selected the provider/s the patient wishes to be seen at you can then either: Book the patient s appointment (ONLY for Directly Bookable Services DBS) see Step 3 Generate an appointment request (this is used for the booking to be made at a later stage; e.g. patient books their own appointment or the service is indirectly bookable) see Step 4. Step 3: Booking the patients appointment on e-rs (ONLY for Directly Bookable Services DBS) Click Appointment Search in the bottom right hand corner 7_How_to_ERS-screenshots_v0.1 www.nelcsu.nhs.uk 4
Select the appointment patient wants to book into Click Book Note: This screen displays all available appointments for all Service locations that you have selected in the previous screen. If you have selected more than one Service location, you can filter to view the appointment for each location by deselecting the Service and clicking on Update Appointment List. Check Patient Details box to confirm patient s details. Click OK to proceed (patient details should have been checked at the point of initiated the referral from EMIS. Note: if the Service needs to contact the patient, it is important that the Consent to Call Back the patient has been recorded Click Update Person At the bottom left of the screen, the Consent Call back Centre option should be recorded as Expressed Consent 7_How_to_ERS-screenshots_v0.1 www.nelcsu.nhs.uk 5
Check the details To confirm, click Submit in the bottom right hand corner. Then click Submit again. Click Print Select Appointment Summary with Password and give the documentation to the patient Note: Some services (LIMS & Antenatal assessment service) do not require patients to receive the patient documentation. Go to Step 5 (Attaching the clinical referral information to the patients UBRN) 7_How_to_ERS-screenshots_v0.1 www.nelcsu.nhs.uk 6
Step 4: Generating an appointment request for the patient Having selected the provider/s the patient wishes to be seen at click Request To ensure that the patient is suitable to be referred to the clinic, review the Conditions Treated, Procedures performed and/or any Exclusions, click on the Service. Click Continue with selected services On the next two screens, click Submit Then Print the summary with password and give the documentation to the patient 7_How_to_ERS-screenshots_v0.1 www.nelcsu.nhs.uk 7
Step 5: Attaching the clinical referral information to the UBRN (Unique Booking Reference Number) Having either booked the appointment for the patient or generated an appointment request, the clinical referral information (e.g. referral letter, test results) now needs to be sent with the e-rs referral. Click on Please select an action (at bottom of the screen) and select I have selected a service Click OK Note: If the referral is no longer needed, select I have abandoned the process The NHS e-referrals Service closes, and the NHS e-referral screen is displayed in EMIS Web with some fields already completed. Complete the Clinical Term field by either entering the referral term or using the search facility. Depending on local processes you may want to create the letter now or later, therefore either: Click on Create Now (this will open the Generate NHS e- Referral window so that you can attach clinical information to the UBRN) Or Click on User/Team to select the staff member responsible for attaching the referral details (i.e. either yourself or administration staff depending on local processes) Click OK Go to Step 6: Attach clinical referral letter later 7_How_to_ERS-screenshots_v0.1 www.nelcsu.nhs.uk 8
Using the tabs on the left hand side you can then upload the relevant information for the referral: NHS e-referral Text: The free-text box is mandatory (e.g. type please see attached referral letter ). Referral Letter: Only use this option if you are selecting and completing the referral template from EMIS. Clinical Content: Allows you to attach pre-written and saved referral letters/forms and/or select other relevant information or attachments including medication, consultations, allergies etc. Preview allows you to view what the provider will see. Once all relevant information is selected, send the referral information to e-rs by clicking on Authorise and Send. Note: Once authorise and send is clicked, this will send the clinical referral information to e-rs and the UBRN details will be saved in the patient s electronic record. 7_How_to_ERS-screenshots_v0.1 www.nelcsu.nhs.uk 9
Step 6: How to attach the clinical referral information later or additional information to the e-rs referral Within EMIS, ensure the correct patient is selected before you attach the clinical referral information to their UBRN. There are two ways to attach the clinical referral information to the patients UBRN. a) From the Referrals tab Find the correct referral Right click on the referral and select Edit Click OK On the next two screens click Yes and then OK 7_How_to_ERS-screenshots_v0.1 www.nelcsu.nhs.uk 10
b) From the Referral Management section in Workflow Manager Select Referral Management Click on Pending Letter Click on the patient to highlight and then Click on Open Letter OR Double click on the patient you need to attach clinical information to their e-rs referral The NHS e-referral Letter Text box will now appear to attach clinical referral information to the patients UBRN. 7_How_to_ERS-screenshots_v0.1 www.nelcsu.nhs.uk 11
Using the tabs on the left hand side you can then upload the relevant information for the referral: NHS e-referral Text: The free-text box is mandatory (e.g. type please see attached referral letter ). Referral Letter: Only use this option if you are selecting and completing the referral template from EMIS. Clinical Content: Allows you to attach pre-written and saved referral letters/forms and/or select other relevant information or attachments including medication, consultations, allergies etc. Preview allows you to view what the provider will see. Once all relevant information is selected, send the referral information to e-rs by clicking on Authorise and Send. Once the clinical referral information has been attached to the patient s e-rs, the UBRN will be recorded in the patient s record. 7_How_to_ERS-screenshots_v0.1 www.nelcsu.nhs.uk 12