NHS e-Referral Service (e-RS) open data dashboard

This data shows weekly data on referrals, bookings and appointment slot issues (ASIs) performed through e-RS. Appointment slot issues are where there are no slots available for booking at the time of search, and the case enters a process for the provider to resolve. These data are being made available to allow for their use in public health enabling more analysis, modelling and planning to be performed and to see changes over time. 
The NHS e-Referral Service (e-RS) provides an easy way for patients to choose their first hospital or clinic appointment with a specialist. Bookings can be made by the patient online, using the telephone, or directly in the GP surgery at the time of referral. Under the NHS Standard Contract, all GPs in England use e-RS to make all referrals to consultant-led outpatient services.

The dashboard is updated weekly, and the underlying data updated every month. The data set presents ICB – sub group level data by specialty and week.

This dashboard data is updated every week, with data covering from 31 December 2019 up to the previous week (Mon – Sun). The open data is updated every month to include data for the previous 4/5 weeks, covering from 7 October 2019.

Due to the impact of coronavirus (COVID-19), several weeks data show a higher number of appointment slot issues than the number of referrals raised. This may be due to the cancellation of routine appointments, and the subsequent re-booking attempts made by patients.

The interactive dashboard which accompanies these open data files includes only data for ICB – sub group organisations. The open data files include referrals, bookings and appointment slot issues from both ICB – sub group and non-ICB – sub group organisations. Therefore, users of the open data files may wish to include or exclude data from the non-ICB – sub group organisations from their own analyses.

ICB – sub group organisations are as of 1 April 2022 and include the July 2022 ICB – sub group mergers.

From July 2023, the dashboard update frequency has been increased to a weekly update, with the open data files retaining a monthly update.

With the publication of the e-RS provider dashboard (e-RS Provider dashboard), the methodology of the public open data dashboard has been updated to improve accuracy and ensure consistency between dashboards. As a result of the change in methodology, the following differences have been observed using a national count for a select reporting period;

Reported measures

The number of events are the number of referrals, bookings or ASIs per week after adjustment for bank holidays.

4-week rolling average is the mean number of referrals, bookings or ASIs per week for the last 4 consecutive weeks (rolling 4-week period), after adjustment for bank holidays.

Referral rate is the number of initial referrals per 10,000 population (patients registered at a GP practice) per week, after adjustment for bank holidays.

Bookings rate is the number of bookings per 10,000 population (patients registered at a GP practice) per week, after adjustment for bank holidays.

ASI rate is the number of ASIs per 10,000 referrals (number of referrals in e-RS) per week, after adjustment for bank holidays.

4-week rolling event rate is the mean number of events per 10,000 population per week for the last 4 consecutive weeks (rolling 4-week period), after adjustment for bank holidays.

The percentage change is the percentage change in number of referrals, bookings or ASIs from the baseline. The baseline was defined as the average number of referrals, bookings or ASIs per week between 7 October and 29 December 2019. This period was chosen as it was unlikely to be affected by COVID-19.

Referral data

A referral in e-RS is defined as a request to another clinician to assist with management of a patient's health issue, this may result in creating an appointment request with a shortlist of suitable services, into one of which the patient may book an appointment. Each referral has a unique booking reference number (UBRN). Referral data includes initial referrals for all priorities, specialties, and clinic types. Two week wait (2WW) clinic types are displayed, all other clinic types have been grouped into 'Other clinic'.

Booking data

Bookings data includes the number of successful initial bookings made as the result of a referral.  A booking may be made at the same time as a referral, or at a later date.  It includes bookings of referrals previously on the Appointment Slot Issues (ASI) worklist, provided the provider updates the e-referral system with the booking information. For non-2WW bookings, this set of data includes First Outpatient bookings only. For 2WW bookings, the data includes bookings for all appointment types. Only the first record of a converted Unique Booking Reference Number (UBRN) is counted (unique UBRNs). Subsequent activity such as rebooking is ignored.

2WW clinic types are displayed, all other clinic types have been grouped into 'Other clinic'.

Appointment Slot Issue (ASI) data

Appointment slot issue (ASI) data - during the appointment booking process e-RS will allow the referral to enter the ASI process if there are no slots available for booking at the time of the appointment search. This action is called 'Defer to Provider'. Each time the referral is deferred the referral will appear on the service provider's 'appointment slot issues' worklist. It is this action we are reporting.

The data represents every ASI action recorded during the reporting period. 2WW clinic types are displayed, all other clinic types have been grouped into 'Other clinic'.