The RNOH aims to be a world-leading orthopaedic hospital with the best patient care and staff experience in the NHS

E-referrals: paper switch off plan

What is paper switch off (PSO)?

Paper Switch Off (PSO) is a national programme, driven by NHS England, to stop the use of paper referrals to consultant led first outpatients appointments. The Trust will not be paid for any appointments resulting from a paper referral that is received from 1st October 2018 and the RNOH must achieve PSO by September 2018.

RNOH is moving to digital-only referrals for consultant-led appointment using the e-referral service (e-RS).

Any referrals sent by post, fax or email after 1st August 2018 will be returned to the referring GP via email without an appointment and we will request that the GP refer via e-RS. By having a single route of access the Trust expects to improve services for both patients and GPs. We will be working in parallel to review and improve areas where capacity constraints are causing appointment slot issues (ASIs).

Time Frames for e-RS Services availability and Paper Switch Off Dates

To support this there will be a phased rollout of services that will only be accepting GP referrals electronically via e-RS:

Specialty Consultants Go live on e-RS Date Paper switch off Date
Chronic Pain Dr Berman, Dr Fernandez, Dr Mihaylov, Dr Varela, Dr Zarnegar 29/05/2018 26/06/2018
Foot and Ankle Mr Cullen, Mr Singh, Mr Welck March 2018 01/05/2018
Joint Reconstruction (JRU) Mr Aston, Mr Carrington, Mr Donaldson, Mr Gikas, Mr Hart, Mr Jayadev, Mr Johnston, Mr Miles, Mr Pollock, Mr Skinner 04/06/2018 23/07/2018
Medicine and Rehabilitation Dr Boppana, Dr Bubbear, Dr Cohen, Dr Keen, Dr Mittal, Dr Wolman April 2018 04/06/2018
Paediatrics Mr Calder, Miss Eastwood, Mr Goodier, Mr Hashemi-Nejad Dr Huma, Dr Jacobs, Mr Khan, Dr Mohamed, Dr McKenna, Dr Oren, Miss Tennant March 2018 02/07/2018
Peripheral Nerve Injury (PNI) Mr Fox, Mr Quick, Mr Sinisi 18/06/2018 16/07/2018
Sarcoma Mr Aston, Mr Gerrand, Mr Gikas, Mr Johnston, Mr Pollock, 16/07/2018 20/08/2018
Spinal Deformity Mr Anwar, Mr Gibson, Mr Lehovsky, Mr Leong, Mr Molloy, Mr Noordeen 11/06/2018 02/07/2018
Spinal Degeneration and Cervical Spine Mr Altaf, Mr Casey, Mr Lee, Mr Rezajooi 11/06/2018 02/07/2018
Spinal Injures Dr Desai, Dr Gall, Dr Gawronski, Mr Hamid, Mr Lee, Mr Shah 11/06/2018 02/07/2018
Upper Limb Mr Falworth (not currently accepting new referrals), Miss Higgs, Mr Majed, Mr Rudge 18/06/2018 16/07/2018

Completion dates above in bold have been achieved.

Once GP paper referrals have been switched off, specialties will be using a rejection process to return any paper referrals back to the referring practices. These patients will not be registered or booked appointments with our Trust.

Referral Rejection Process
As services switch off paper, the RNOH will return paper referrals to GPs advising on how to re-refer via e-RS. Patients will not receive an appointment until a referral has been received via e-RS. It is also important to ensure that referrers ensure that referral letters are attached to e-RS within 24 hours of the appointment being booked to avoid delays and appointments being cancelled.

The number of paper referrals will be monitored and persistent non-compliance will be escalated to the relevant CCG as per the national guidelines as this is classed as a clinical risk.

Key Contacts

If you have any concerns or Queries about e-RS / problems finding clinics/ paper switch-off process.

Amanda Peel, Elective Access Manager

Please contact the Elective Access Management Team at ers.RNOH@nhs.net

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