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What are practices' contractual obligations on e-referrals?

As part of the 2018/19 GP contract it will be a contractual requirement for practices to use the NHS e-Referral Service (e-RS) for all referrals to first consultant-led outpatient appointments from October 2018.

Changes to the standard hospital contract mean that from October they will only be paid for standard referrals if they are through e-RS. Because of this, many CCGs are already working with practices and hospitals to ensure this system is rolled out.

However to achieve full coverage, it will become a contractual requirement for practices to ensure that all referrals to a first consultant-led outpatient appointments are made via the system.

Latest figures from December 2017 suggest that at present 62% of these referrals are made through the system so there is clearly still some way to go.

What must practices do?

The BMA says that new guiance will make clear that this requirement 'does not mean that individual GPs have to use the e-RS system themselves'. It says that there are a vareity of models that practices can adopt and it is up to practices to decide how much of this work is undertaken by administrative teams.

NHS Employers says that from now until October the e-RS team will be working closely with CCGs and practices to provide support to hit full roll out. It says that where there is concern from local GPs, CCGs should 'meet with them, to listen and understand those concerns and jointly develop and deliver action plans to address any issues.'

National guidance created by the GPC and NHS England, along with videos and training materials, will be available shortly. This will outline how practices can implement e-RS.

What happens if the practice can't cover 100% of referrals?

The GPC says that it has secured agreement 'that NHS England will take a supportive not punitive approach where circumstances dictate that practices are unable' to meet this objective. Instead a supporting action plan should be agreed to help practices to achieve this goal.

Practices will also not be penalised if e-RS is not fully implemented in their area, for example where services are not available to refer into or if there are IT problems. CCGs should work with LMCs and practices to ensure local system issues are appropriately resolved.

The GPC says that if practice experience problems with local hosptals or the e-RS system they should contact their LMC or the GPC itself.

Funding and other issues

There is £10m of non-recurrent funding in the 2018/19 contract to 'ensure practices are financially supported to implement the system'.

The GPC will be working with NHS England over the next year to ensure the system is working correctly and making any changes that are necessary and this will inform the next round of contract negotiations.

Full details of 2018/19 GMS contract in England

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