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Standard Operating Procedure (SOP) for e-Referrals Service Paper Switch offWestern Sussex Hospitals NHS Foundation Trust Worthing, Southlands & St Richards Hospitals
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Contents1. Purpose of SOP...........................................................................................................................3
2. Scope.............................................................................................................................................3
In Scope............................................................................................................................................3
Out of Scope.....................................................................................................................................3
3. Pre-requisites...............................................................................................................................4
4. Strategies for Managing and Reducing Appointment Slot Issues.........................................4
5. Responsibilities............................................................................................................................5
6. Appendix.......................................................................................................................................5
Appendix I - List of services available on e-RS...............................................................................6
Appendix II - Process Map – Managing a GP Paper Referral.....................................................14
Appendix III - Email – Auto reponse from GP Inbox WSHNT.outpatientappointments@nhs.net....................................................................................15
Appendix IV - GP Practice Contact Details....................................................................................16
Appendix V – Paper Switch off Log.................................................................................................17
Appendix VI – Monthly reporting Template....................................................................................18
Appendix VII - Process Guide – Roles and Responsibilities a GP Paper Referral...................19
Appendix VIII – Business Continuity Process................................................................................20
7. Version Control and Sign off Documentation.........................................................................22
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1. Purpose of SOPThis SOP explains the process for managing GP paper referrals that are received by the Trust and how we work with our GP providers and to ensure the referrals are submitted via the electronic e-Referral Service.
2. ScopeThis SOP applies to all GP referrals that are submitted by paper for all specialties available on the e-Referral Service
In ScopePaper referrals received for specialties which are available for booking via the e-Referral Service (Appendix 1 , full list of services available on e-RS)
Out of ScopeService Reason for exclusion
Emergency clinics – all specialties Not booked in advance
EPAC Not booked in advance
Fracture clinics Usually referred via A&E
Obstetrics Usually referred from midwives
Rapid access clinics Usually seen within 24 hours and eRS does not support this functionality
Mental Health services National exclusion
Consultant to consultant National exclusion
Referrals from dentists National exclusion
Referrals from optometrists National exclusion
Referrals from prison GPs National exclusion
Referrals for Defence Medical Services patients based outside England
National exclusion
Referrals from private GPs National exclusion
Referrals from out of hours GPs National exclusion
Referrals for Scottish or Welsh registered patients
National exclusion
Patients without a NHS number National exclusion
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Referrals for follow up appointments
National exclusion
Patients who have opted out of having their information transferred electronically
National exclusion
3. Pre-requisites Appropriate training to be provided for all relevant staff. E-Referrals system and functionality available. Full sign off and approval by the Project Board and CCG representatives (including
LMC/IPC)
4. Strategies for Managing and Reducing Appointment Slot Issues
Strategies for Reducing Appointment Slot Issues
Ensure that e-RS capacity management is embedded in existing capacity management review processes, supported by strong escalation processes.
Ensure that slot poll ranges align with or exceed waits for patients referred by other means
Allocate all new slots to the NHS e-Referral Service
Enable referrers to request Advice and Guidance through the NHS e-Referral Service
Providers are contractually required to ensure that sufficient appointments slots for first outpatient appointments are available on NHS e-Referral
Responsible Actions to minimise Appointment Slot Issues
Waiting List Manager/Call Centre Supervisor/Outpatient Booking Team
Daily: monitoring of ‘Slot Availability’ enquiries in e-RS providing real-time information on used and unused slots over a specified time period (Diag.1).
Adjust polling range as necessary to maintain appointment availability.
Make full use of the appropriate tools within e-RS such as Future Slot Utilisation report to increase awareness of future possible capacity issue.
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Waiting List Manager/Call Centre Supervisor
Ensure that e-RS capacity management is embedded in existing capacity management review process supported by strong escalation process.
Ensure that slot poll ranges always align with or exceed current outpatient waits.
Enable referrers to request Advice and Guidance as an alternative to Outpatient appointment when appropriate.
Whenever possible the Waiting List Manager or Call Centre Supervisor will release extra capacity using Poll Now function to avoid an ASI.
In conjunction with Care Group Managers consider creating additional capacity by offering non consultant led services where appropriate.
Daily: Report on ASIs by specialty and site Weekly: Identify services at risk of creating ASIs Identify services where an excessive polling range
is required which could lead to RTT non- compliance. Escalate these services to Care Group Managers.
PCN/Waiting List Manager/Call Centre Supervisor
In the event of slot unavailability the PCN will contact WSHFT Waiting List Manager or Call Centre Supervisor prior to selecting ‘Deferring to Provider’. Whenever possible WSHFT will utilise the ‘poll now’ function to create appointment capacity and avoid an ASI.
Diag.1
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5. Responsibilities The Head of Elective Patient Access will be responsible for updating the SOP. Directorates and Divisional Operational Teams are to ensure SOP is followed and performance managed against this standard.
Administration and Booking Teams escalating to Head of Elective Patient Access if the process cannot be achieved.
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6. AppendixI. List of services available on e-RS
II. Process Map – Managing a GP Paper referral for ‘hard switch off’III. Email Script to GP (return of referrals)IV. GP Practice Contact DetailsV. Paper Switch Off LogVI. Monthly Reporting Template
VII. Roles and Responsibilities a GP Paper ReferralVIII. Business Continuity Process
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Appendix I - List of services available on e-RS
2WW - Bone Disorders and Sarcoma Assessment Service - St Richards Hospital - RYR16
2WW - Bone Disorders and Sarcoma Assessment Service - Worthing Hospital - RYR18
2WW - Breast Services - DO NOT ATTEND APPOINTMENT ASSESSMENT ONLY Worthing Hospital - RYR18
2WW - Breast Services DO NOT ATTEND APPOINTMENT ASSESSMENT ONLY- Chichester Treatment Centre - RYR05
2WW - Children's & Adolescent Services - St Richard's Hospital - RYR16
2WW - Children's & Adolescent Services - Worthing Hospital - RYR18
2WW - Colorectal Service DO NOT ATTEND APPOINTMENT ASSESSMENT ONLY - Worthing Hospital - RYR18
2WW - Colorectal Service DO NOT ATTEND APPOINTMENT ASSESSMENT ONLY- Chichester Treatment Centre - RY
2WW - Dermatology Service - Bognor War Memorial Hospital - RYR02
2WW - Dermatology Service DO NOT ATTEND - ASSESSMENT ONLY- Southlands Hospital - RYR14
2WW - Dermatology Service DO NOT ATTEND APPOINTMENT ASSESSMENT ONLY- Worthing Hospital - RYR18
2WW - Dermatology Service DO NOT ATTEND, ASSESSMENT ONLY- St Richard's Hospital - RYR16
2WW - ENT - DO NOT ATTEND - ASSESSMENT ONLY Worthing Hospital - RYR18
2WW - Gastroenterology Service - Chichester Treatment Centre - RYR05
2WW - Gastroenterology Service DO NOT ATTEND ASSESSMENT ONLY - Worthing Hospital - RYR18
2WW - Gastroenterology Service DO NOT ATTEND ASSESSMENT ONLY- St Richard's Hospital - RYR16
2WW - Gyanecology Services - Southlands Hospital - RYR14
2WW - Gynaecology Services - St Richard's Hospital - RYR162WW - Gynaecology Services - Worthing Hospital - RYR18
2WW - Haematology Service - St Richard's Hospital - RYR16
2WW - Haematology Service - Worthing Hospital - RYR18
2WW - MFU Service - Southlands Hospital - RYR14
2WW - MFU Service - St Richard's Hospital - RYR16
2WW - MFU Service - Worthing Hospital - RYR18
2WW - Neurology - Southlands Hospital - RYR14
2WW - Neurology Service - St Richard's Hospital - RYR16
2WW - Neurology Service - Worthing Hospital - RYR18
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2WW - Ophthalmology Services - St Richard's Hospital - RYR16
2WW - Ophthalmology Services - Southlands Hospital - RYR14
2WW - Respiratory Service ASSESSMENT ONLY - Worthing Hospital - RYR18
2WW - Respiratory Service ASSESSMENT SERVICE - St Richard's Hospital - RYR16
2WW - Soft Tissue Sarcoma Assessment Service - St Richards Hospital - RYR16
2WW - Soft Tissue Sarcoma Assessment Service - Worthing Hospital - RYR18
2WW - Urology Service - Chichester Treatment Centre - RYR05
2WW - Urology Services - Southlands Hospital - RYR14
Adult Hearing Loss - Audiology - DO NOT ATTEND APPOINTMENT - Assessment only
Ankle Service - Orthopaedics - St Richard's Hospital - RYR16
Asthma Clinic Service - Respiratory - Worthing Hospital - RPL04
Balance & Dizziness Service - Ear, Nose and Throat - Worthing Hospital - RPL04
Cardiology - DO NOT ATTEND APPOINTMENT - Assessment Only - St Richards Hospital - RYR16
Cardiology - DO NOT ATTEND APPOINTMENT - Assessment Only - Worthing Hospital - RPL04
Cataract Service - Ophthalmology - Southlands Hospital - RPL03
Cataract Service - Ophthalmology - St Richard's Hospital - RYR16
Children's & Adolescent Services - Allergy Service ASSESSMENT ONLY - Worthing Hospital - RPL04
Children's & Adolescent Services - Cardiology ASSESSMENT ONLY - St Richards Hospital
Children's & Adolescent Services - Cardiology ASSESSMENT ONLY - Worthing Hospital - RPL04
Children's & Adolescent Services - Dermatology - St Richard's Hospital - RYR16Children's & Adolescent Services - Dermatology - Worthing Hospital - RPL04
Children's & Adolescent Services - ENT - Worthing Hospital - RPL04
Children's & Adolescent Services - Gastroenterology ASSESSMENT ONLY - St Richard's Hospital - RYR16
Children's & Adolescent Services - Gastroenterology ASSESSMENT ONLY - Worthing Hospital - RPL04
Children's & Adolescent Services - General - Southlands Hospital - RPL03
Children's & Adolescent Services - General Medicine - Littlehampton Health Centre - RPL08
Children's & Adolescent Services - General Medicine - Worthing Hospital - RPL04
Children's & Adolescent Services - General Service - Maywood Health Centre - RYR26
Children's & Adolescent Services - General Service - Pulborough Medical Centre - RYR11
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Children's & Adolescent Services - General Service - St Richard's Hospital - RYR16
Children's & Adolescent Services - Neurology ASSESSMENT ONLY - Worthing Hospital - RPL04
Children's & Adolescent Services - Orthopaedics - St Richard's Hospital - RYR16
Children's & Adolescent Services - Respiratory ASSESSMENT ONLY - St Richard's Hospital - RYR16
Children's & Adolescent Services - Respiratory ASSESSMENT ONLY - Worthing Hospital - RPL04
Children's & Adolescent Services - Surgery - ASSESSMENT ONLY - St Richard's Hospital - RYR16
Children's & Adolescent Services - Surgery - ASSESSMENT ONLY - Worthing Hospital
Children's & Adolescent Services - Urology - Worthing Hospital - RPL04
Children's & Adolescent Services - Urology (Male only) - St Richard's Hospital - RYR16
Colorectal Surgery Service - Chichester Treatment Centre - RYR05
Colorectal Surgery Service - Worthing Hospital - RPL04
Colposcopy Service - DO NOT ATTEND APPOINTMENT - Assessment Only - Southlands Hospital - RPL03
Colposcopy Service - DO NOT ATTEND APPOINTMENT - Assessment Only - St Richard's Hospital - RYR16
Continence Service - Urology - Chichester Treatment Centre - RYR05
Continence Service - Urology - Worthing Hospital - RPL04
Corneal/Blepherospasm Service - Ophthalmology - Southlands Hospital - RPL03
Corneal/Blepherospasm Service - Ophthalmology - St Richard's Hospital - RYR16
Dermatology ACUTE Service - Dermatology - Southlands Hospital - RPL03
Dermatology ACUTE Service - Dermatology - Bognor War Memorial Hospital - RYR02
Dermatology ACUTE Service - Dermatology - St Richard's Hospital - RYR16
Dermatology ACUTE Service - Dermatology - Worthing Hospital - RPL04
Diabetic Foot Ulcer Service - Diabetic Medicine - Worthing Hospital - RPL04
Diabetic Retinopathy Service - NOT SCREENING - Ophthalmology - Southlands Hospital - RPL03
Diabetic Retinopathy Service NOT SCREENING - Ophthalmology - St Richard's Hospital - RYR16
Diabetic Service - Diabetic Medicine - St Richard's Hospital - RYR16
Diabetic Service - Diabetic Medicine - Worthing Hospital
Elbow Service - Orthopaedics - St Richard's Hospital - RYR16
Endocrinology Service - Endocrinology - Worthing Hospital - RPL04
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Endocrinology Service - Endocrinology and Metabolic Medicine - St Richard's Hospital - RYR16
ENT Service - ENT - Worthing Hospital - RPL04
Facial Plastics Service - ENT - Worthing Hospital - RPL04
Foot and Ankle Service - Orthopaedics - Southlands Hospital - RPL03
Foot and Ankle Service - Orthopaedics - Worthing Hospital - RPL04
Foot Service - Orthopaedics - St Richard's Hospital - RYR16
Gastroenterology (including Hepatology) DO NOT ATTEND Assessment only - Southlands Hospital - RPL03
Gastroenterology (including Hepatology) DO NOT ATTEND Assessment Only - Worthing Hospital - RPL04
Gastroenterology Assessment Service - GI and Liver - Chichester Treatment Centre - RYR05
Gastroenterology DO NOT ATTEND APPOINTMENT Assessment Only - St Richard's Hospital - RYR16
General Medicine Service - General Medicine - St Richard's Hospital -RYR16
General Medicine Service - Worthing Hospital - RPL04
General Ophthalmology Service - Southlands
General Ophthalmology St Richards Hospital
Geriatric Service - Geriatric Medicine - St Richard's Hospital - RYR16
Geriatric Service - Geriatric Medicine - Worthing Hospital - RPL04
Glaucoma Service - DO NOT ATTEND APPOINTMENT - Assessment Only - Southlands Hospital - RPL03
Glaucoma Service - DO NOT ATTEND APPOINTMENT - Assessment Only - St Richards Hospital - RYR16
Gynaecology Service - Gynaecology - Southlands Hospital - RPL03
Gynaecology Service - Gynaecology - St Richard's Hospital - RYR16
Gynaecology Service - Gynaecology - Worthing Hospital - RPL04
Haematology Assessment Service - St Richards Hospital - RYR16
Haematology Assessment Service - Worthing Hospital - RPL04
Hand & Wrist Service - Orthopaedics - Worthing Hospital - RPL04
Hand/Wrist Service - Orthopaedics - St Richard's Hospital - RYR16
Head and Neck Service - Dermatology - St Richard's Hospital - RYR16
Head and Neck Service - Oral and Maxillofacial Surgery - St Richard's Hospital - RYR16
Hernia/General Surgery Service - Bognor War Memorial Hospital - RYR02
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Hernia/General Surgery Service - Southlands Hospital - RPL03
Hernia/General Surgery Service - St Richard's Hospital - RYR16
Hernia/General Surgery Service - Worthing Hospital - RPL04
Hip Service - Orthopaedics - Southlands Hospital - RPL03
Hip Service - Orthopaedics - St Richard's Hospital - RYR16
Hip Service - Orthopaedics - Worthing Hospital - RPL04
Hypertension Service - Endocrinology and Metabolic Medicine - St Richard's Hospital - RYR16
Hypertension Service - General Medicine - St Richard's Hospital - RYR16
Hypertension Service - Geriatric Medicine - St Richard's Hospital - RYR16
Hysteroscopy Service - DO NOT ATTEND APPOINTMENT - Assessment Only - St Richard's Hospital - RYR16
Hysteroscopy Service - DO NOT ATTEND APPOINTMENT- Assessment Only - Southlands Hospital - RPL03
Knee Service - Orthopaedics - Southlands Hospital - RPL03
Knee Service - Orthopaedics - St Richard's Hospital - RYR16
Knee Service - Orthopaedics - Worthing Hospital - RPL04
Lacrimal Service - Ophthalmology - Southlands Hospital - RPL03
Lacrimal Service - Ophthalmology - St Richard's Hospital - RYR16
Lipid Service - Endocrinology - St Richard's Hospital - RYR16
Maxillo Facial Service - Oral and Maxillo-facial Surgery - St Richard's Hospital - RPR01
Maxillo-Facial Service - Oral and MFU Surgery - Southlands Hospital - RPL03
Maxillo-Facial Service - Oral and MFU Surgery - Worthing - RPL04
Medical Retinal/Vitreo Retinal Service - Ophthalmology- Southlands Hospital - RPL03
Medical Retinal/Vitreoretinal Service - Ophthalmology - St Richard's Hospital - RPR01
Menorrhagia Service - Gynaecology - Southlands Hospital - RPL03
Menorrhagia Service - Gynaecology - Worthing Hospital - RPL04
Menstrual Disorders Service - Gynaecology - Southlands Hospital - RPL03
Menstrual Disorders Service - Gynaecology - Worthing Hospital - RPL04
Nasal Disorders Service - ENT - Worthing Hospital - RPL04
Nephrology Service - Nephrology - Worthing Hospital - RPL04
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Neurology - DO NOT ATTEND APPOINTMENT - Assessment Service only - Worthing Hospital - RPL04
Neurology DO NOT ATTEND APPOINTMENT Assessment Service Only - St Richard's Hospital - RYR16
Oculoplastics Service - Ophthalmology - Southlands Hospital - RPL03
Oculoplastics Service - Ophthalmology - St Richard's Hospital - RYR16
Ophthalmology General Triage Service - Southlands ASSESSMENT ONLY
Ophthalmology General Triage Service ASSESSMENT ONLY- St Richards Hospital
Pain Management Service - Pain - Southlands Hospital - RPL03
Pain Management Service - Pain - St Richard's Hospital - RYR16
Parkinsons Service - Neurology - St Richard's Hospital - RYR16
Pelvic Pain & Endometriosis Service - Gynaecology - Southlands Hospital - RPL03
Pelvic Pain & Endometriosis Service - Gynaecology - Worthing Hospital - RPL04
Respiratory Medicine Service - Respiratory - Worthing Hospital - RPL04
Respiratory Service - Respiratory - St Richard's Hospital - RYR16
Respiratory Service - Respiratory Medicine - Bognor War Memorial Hospital - RYR02
Revision Hip Service - Orthopaedics - Southlands Hospital RYR14
Revision Hip Service - Orthopaedics - St Richard's Hospital - RYR16
Rheumatology Service - Rheumatology - Southlands Hospital - RPL03
Rheumatology Service - Rheumatology - St Richard's Hospital - RYR16
Rheumatology Service - Worthing Hospital - RPL04
Shoulder & Elbow Service - Orthopaedics - Worthing Hospital - RPL04Shoulder and Elbow Service - Orthopaedics - Southlands Hospital - RPL03
Shoulder Service - Orthopaedics - St Richard's Hospital - RYR16
Spinal Triage Service - Rheumatology - Southlands Hospital - RPL03
Spinal Triage Service - Rheumatology - Worthing Hospital - RPL04
Squint & Paediatric Ophthalmology - Ophthalmology - Southlands Hospital - RPL03
Squint & Paediatric Ophthalmology - Ophthalmology - St Richards Hospital - RYR16
Symptomatic Breast Surgery Service - Chichester Treatment Centre - RYR05
Symptomatic Breast Surgery Service - Worthing Hospital - RPL04
Thyroid Service - ENT - Worthing Hospital - RPL04
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Thyroid/Endocrine Service - General Surgery - St Richard's Hospital RYR16
Upper GI Surgery Service - GI and Liver - Worthing Hospital - RPL04
Upper GI Surgery Service - GI and Liver - Southlands Hospital - RPL03
Upper GI, Laparoscopic & General Surgery Service - Chichester Treatment Centre - RYR05
Urogynaecology (Incontinence and Prolapse) Service - Gynaecology - St Richard's Hospital -RYR16
Urogynaecology Service - Gynaecology - Southlands Hospital - RPL03
Urology (General) - Chichester Treatment Centre - RYR05
Urology (General) - Southlands Hospital - RPL03
Urology (General) - Worthing Hospital - RPL04
Vascular Service - Worthing Hospital - RPL04
Vascular Surgery - Vascular - St Richard's Hospital - RYR16
Vulval Irritation Service - Gynaecology -St Richard's Hospital - RYR16
YAG Laser - Ophthalmology - Southlands Hospital - RPL03
YAG Laser - Ophthalmology - St Richards Hospital - RYR16
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Appendix II - Process Map – Managing a GP Paper Referral
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Appendix III - Email – Auto reponse from GP Inbox [email protected]
Re: Paper Switch Off at Western Sussex Hospitals NHS Foundation Trust – NHS e-Referral Service
All of our consultant led services are live on e-RS and referrals to these services should be made via e-RS. This referral has been accepted and processed.
The following services are excluded and should continue to be sent as a non e-RS referral using existing processes:
Emergency clinics Early Pregnancy Assessment Clinic Fracture Clinics Maternity Rapid Access Clinics Sexual Health
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Appendix IV - GP Practice Contact Details
List of ‘safe’ e-mail addresses TBC
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Appendix V – Paper Switch off Log
To support the reporting element of the Paper Switch off process, there will need to be a log kept manually for any paper referrals received from the 2nd July launch. The log will be used to support the reporting required by NHS England on a monthly basis and completed by the PCN at WSHFT as outlined in the process for Appendix II - Process Map – Managing a GP Paper Referral from Hard Switch Off (Routine referrals)
Example of log Template
e-RS Project - Paper Switch-Off log
Patient Name NHS NumberGP
PracticeDate of referral Specialty
Date Referral Received
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Appendix VI – Monthly reporting Template
The Trust produce reporting during the Paper Switch off phase, to determine the impact of the soft launch and the number of referrals which are continuing to be received into the Trust for those services which are available on e-RS in Paper, against those which are being received electronically.
The trust is also required to send a monthly report to the CCG’s and NHS England.
The report format will follow the format currently used on a monthly basis to report on WSHFT utilisation of e-RS.
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Appendix VII - Process Guide – Roles and Responsibilities a GP Paper Referral
Responsibility Description/Process
Head of Elective Patient Access
To be the subject matter expert for the paper switch off process for WSHFT and to cascade information to other booking team Managers and operational teams
Medical SecretariesTo forward all referrals from GP to Consultant led services to the Referral hub
Referral HubTo process eRS and out of scope referrals, entering into the Trusts clinical information systems as appropriate
PCN hub at WSHFTTo define in scope referrals that are sent ‘non eRS’ and process using the correct pathway
Southlands Booking TeamsProcess and manage the eRS worklists, ensuring that all patients are seen in turn. Managing 2WR clinic booking.
CWS CCGTo monitor the GP practices submitting referrals ‘non eRS’ and promote learning
PCN TeamTo manage the patient flow through eRS from GP practices from entering referrals through to contacting the patients to offer choice
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Appendix VIII – Business Continuity Process
1. In the event that the e-RS system is not available or, for other technical reasons, GP practices or the PCN Team are not able to process a referral using e-RS, the following contingency plans should be used to ensure the safe and timely handling of patient referrals.
2. The PCN Team Leader will notify the referral hub manager when eRS becomes unavailable and that referrals will be held from that time.
3. For routine referrals, GP practices and the PCN Team should hold referrals for up to 48 hours in the event of a technical failure. If unresolved, referrals should then be sent to [email protected].
4. For 2 week wait/urgent referrals, the following steps should be followed if eRS is not available for more than 24 hours:
The referrer should phone the referral hub on 01243 788122 ext 32030 or 01903 205111 ext 85883 to advise that a referral is being sent to the designated email address.
For 2ww referrals email the referral to [email protected] For urgent referrals email the referral to [email protected]
5. The following steps will then be undertaken at the trust:
The referral hub will email the referrer to confirm receipt of referral The Two Week Rule Team will manage the referral and contact the patient with
an appointment
6. As soon as eRS becomes available normal processes will be resumed.
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7. Version Control and Sign off DocumentationVersion Date Amendment History
0.1 06/06/18 Draft for review
0.2 27/06/18 Updated paper returns flow & ASI guidance
0.3
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