1. NHS e-Referral Service Advice and Guidance Patient and User Journey: The Vision …….

2. Advice and Guidance Patient sees GP Mick attends an appointment with his GP Dr Singh, having experienced a “funny turn” at home. He felt his heart beating heavily and irregularly for a few minutes and also felt faint. Dr Singh examines Mick and finds nothing abnormal, but suggests an ECG to help understand what’s been happening. 1

3. Advice and Guidance GP and patient book appointment Dr Singh logs on to the NHS e-Referral Service and requests an ECG diagnostic test. As he wants to know the result as quickly as possible, he helps Mick to find and book an appointment for that same afternoon at a local independent clinic. Mick asks for a printout of the confirmation and the accompanying map. 2

4. Advice and Guidance Patient attends appointment Mick attends the ECG appointment that afternoon. The ECG is generated as an electronic image and uploaded to the NHS e-Referral Service. Mick also receives a copy of the result. 3

5. Advice and Guidance GP reviews results and requests advice Dr Singh receives an email alert indicating that the ECG is now available. He reviews the results but feels he needs a more specialist interpretation. He therefore generates an Advice and Guidance request using the ECG report which he sends to a consultant cardiologist. 4

6. Advice and Guidance Consultant requests additional information Dr Harrison, consultant cardiologist, reviews the request, but doesn’t have enough information to make a decision. She therefore replies to Dr Singh asking for past medical history and any older ECG results. Dr Singh receives an email alert and asks his secretary to upload this additional information. 5

7. Advice and Guidance Consultant advises GP Dr Harrison reviews the additional clinical information and responds to Dr Singh, suggesting that a cardiology referral is needed. 6

8. Advice and Guidance GP generates referral requests Dr Singh discusses referral options with Mick and together they agree a list of three local hospitals from which he can choose. Dr Singh is alerted to the fact that all these services require an Exercise ECG to have been completed. He therefore raises the referral request for both appointments. 7

9. Advice and Guidance Patient receives booking information Mick wants the appointment booking instructions sent electronically, so Dr Singh confirms his contact details and sends the relevant information. 8

10. NHS e-Referral Service vision – making paperless referrals a reality How can YOU get involved? Take part in the consultation at: www.hscic.gov.uk/erswww.hscic.gov.uk/ers Contact us on email: nhs.ers@hscic.gov.uknhs.ers@hscic.gov.uk