1. Patient Quote
“When I needed to be referred to a consultant, I knew where I wanted to go. My GP just provided me with a password, so that I could go away and book the appointment online myself. It’s also really useful to see information about the waiting times at different hospitals, because you can choose to travel a bit further in order to get a quicker appointment.”
Alex Dwiar, a patient at Paxton Green Group Practice, South London

2. GP quote
“e-RS provides a quick and easy way to book appointments online for GPs, their staff and patients. Time from first consultation in primary care to first appointment in secondary care is reduced. You can compare waiting times from a variety of providers and offer patients an informed choice.”
“Once you are used to the system, it has enormous benefits for patients in terms of shortening their waiting time. It also allows you to compose and share a referral letter with the patient present, ensuring they are kept informed and understand what the referral is for and that it is accurate. This can also form the basis of your notes. e-RS gives you the assurance of knowing when the patient’s appointment is going to be, which, if there is a long wait, allows you to plan any follow-up you might need before they are seen.”
Dr Chris Markwick, Darlington 

3. Top-Tips from Dr Chris Markwick,
Book patients’ appointments with them. Patients love this and it allows you to plan follow ups.
Agree a day to start using e-RS and involve the whole practice team.
Explore what the barriers to using e-RS Explore what the barriers to using e-RS at your practice are. Typically time is perceived as an issue, but you can use the technology to reduce the duplication of record keeping and referral writing.
Use the freed up secretarial time to manage other tasks to reduce work load, such as chasing up results.
Use cut and paste or a template which pulls content into a standard letter. Go on a touch type course to speed things up.

4. Use of A&G in Sandwell and West Birmingham Hospitals NHS FT
A review of over 100 A&G requests to a single specialty (Endocrinology) found;
Only 1 in 10 A&G requests were advised to immediately refer the patient
Over 75% were responded to with advice only and did not require a referral
" A recent GP colleague who is a patient of mine was concerned about minor abnormalities on his chest X-ray and was keen for a specialist opinion. As an alternative to a face to face I used the advice and guidance function at SWBH where the test had been taken .Within 48 hours a respiratory consultant had viewed the films and results to date and suggested a plan going forward to arrange a CT chest .I have left the conversation on the e referral service open pending this so I can seek further advice once this has been done. This has been a very convenient way of consulting and closely liaising with my local secondary care colleagues. I have recommended the service to all my colleagues and in particular my gp registrars in training."
Dr Savio Gaspar GP

5. Royal Devon & Exeter: Use of A&G to provide a Teledermatology service
A review of patient outcomes from over 1000 A&G requests found:
2 out of 3 requests result in care being provided in the community
only 1 in 4 patients are seen in clinic
Carolyn Charman, Consultant Dermatologist at RD&E says: The Exeter Teledermatology Service has received over 5000 referrals, with excellent feedback from GPs and patients. The service provides rapid access to diagnosis and management advice from a Consultant-led integrated dermatology team, streamlining patient pathways and strengthening links between primary and secondary care.

6. A&G use across Cambridgeshire and Peterborough
A review of over 8000 A&G requests to providers across Cambridgeshire & Peterborough found ;
only 1 in 3 patients were advised to refer immediately to an outpatient appointment.
“eRS provides an effective way to seek advice and guidance from specialist consultants. It improves communication between primary and secondary care and enhances the relationships between GPs and consultants.
Using advice and guidance can improve the quality of referrals and ultimately the quality of care, by supporting a shared responsibility for patient care and the referrals being made.”
Dr Ben Curtis, GP,
Ramsey Health Centre, Cambridgeshire

7. RAS quote
Sara Thomas
NHS E-Referral Service Performance & Development Manager , Royal Devon & Exeter Hospitals;
“I am really impressed with the RAS functionality, it is working extremely well for our services. Everything has been so easy, the service set up was simple, the roll out seamless and switching off our Clinical Assessment Services has not caused any problems. It is the best thing that the NHS e-Referral Service has done for a long time. It has allowed us to set up services such as dietetics and oncology that would not have been suitable to be set up as bookable services. We are now able to achieve the efficiencies of electronic referral management for these services and remove paper processes”
The booking clerks love it, they can see all their patients in the worklist – they can easily tell which patients are waiting for assessment in the  RAS, something they were not able to do using CAS functionality. This saves them time as they do not have to filter worklists to try and find patients.”