The Royal National Orthopaedic Hospital NHS Trust (RNOH) receives clinical referrals to our specialist, tertiary neuro-musculoskeletal services from primary, secondary and tertiary care institutions regarding both NHS and private patients.

Tertiary referrals to the RNOH from other hospitals

The RNOH has committed to using ‘PATHPOINT’, an electronic referral and pathway management system, for all Consultant-led referrals from secondary and tertiary care organisations. General Practitioners should continue to refer to RNOH using the UK Electronic Referral System (ERS) - please further see below.

PATHPOINT offers significant benefits to referrers:

  • Secure, streamlined, electronic referral forms
  • Receive updates and notifications in real time
  • Increased visibility of all referrals and triage outcomes

The current services to accept PATHPOINT referrals are:

Please note, only the services listed above are using PATHPOINT at this time. For referrals to other services please refer to the respective page for that service.

For further information on the PATHPOINT system, please click here.

To give your feedback, or for any further questions, please email the relevant contact below:

PATHPOINT Technical Support:

Tertiary referrals from other hospitals

These forms are only for tertiary referrals from other hospitals. We will not accept referrals from GPs using the online referral forms below. Please note that from Monday 13 December 2021, tertiary referrals to the Foot and Ankle, Shoulder and Elbow and Limb Reconstruction services are via Pathpoint (please see above).

The following service referrlas ARE NOT currently via Pathpoint:

GPs referring to the RNOH

ERS Guide how to find the RNOH

If you are a GP referring to the RNOH please use the NHS e-Referral Service system, e-RS. Find out more about e-RS and the benefits for patients.

What is e-RS?

E-RS is the NHS electronic patient referral service used to refer patients to a consultant-led service. This is for new first outpatient appointments only. All other appointments must be booked as per the current process.

Benefits for Patients

It gives patients as much choice as possible and where practicable, empowering patients to make the booking themselves.

Improves patient convenience. e-RS allows them to plan their visit for a time that best suits their family and work life.

There is significant evidence that patients who are empowered to choose their own appointment are far more likely to attend their clinic slot.

Similarly, where patients have greater choice, there is a reduction in rearranged appointments.

e-RS provides an electronic trail of records that can be easily traced.

And, by removing paper referrals we can speed up appointment confirmation for patients at the click of a button.

Benefits for the Trust

Patient choice and better control

Safety: referral visibility and audit trail

Operational: easier referral trail, reduction in the number of enquires

Finically: reduced DNA’s and cancellations- data from previous electronic booking pilots show that when patients are given the choice of date and time for their appointment they are more likely to attend. This leads to fewer wasted appointments and helps to improve the efficiency of outpatient clinics

What happens when a patient is referred electronically using e-RS?

Where the service is ‘directly bookable’ patients will have the ability to book into an available appointment (as a provisional appointment) that is convenient for them to attend. The referral will be reviewed (triaged) by the relevant consultant and will be accepted, rejected or referred on (to another RNOH colleague). The outcome of the review will be communicated to the GP and the patient. For rejected referrals, this will mean that the provisional appointment is cancelled and for accepted referrals, it will mean that the provisional appointment is confirmed.

For ‘indirectly bookable’ services, patients will be given a paper by the GP which should contain a UBRN, passcode and a telephone number to call to activate the referral. It is only once the patient calls the RNOH, that the RNOH will have access to the referral information on e-RS. The referral will be passed to the relevant consultant to review and a decision to accept or reject will be made and the patient and GP notified accordingly.

What happened if there are no appointments?

There may be instances where a patient cannot select an appointment (for directly bookable services) when attempting to book the appointment. When this happens, practices or patients should always choose the ‘Defer to Providers’ option. These are known as 'Appointment Slot Issues' and are caused because there are no available slots for the service the patient is being referred to.

Appointment Slot Issues (ASIs) and Defer to the provider

When there is no capacity available for a service on e-RS and referring GPs, use the 'Defer to Provider' option, an Appointment Slot Issue is created. The service will manage the Appointment Slot Issue worklist, create capacity for the Appointment Slot Issue and then book the patient an appointment via e-RS when there is capacity available.

Sarcoma clinics are also supported by the NHS e-Referral Service. Please ensure that the suspected sarcoma referral form is used for all 2WW referrals. This form can be found here Contact Details for GPs and  Pan-London & South East Sarcoma Network Referral Form.

Booking for NHS e-referral service appointment

Patients can book, change or cancel their appointment online and by phone.

To book or amend an appointment online, please visit: NHS e-Referral Service

To book or amend an appointment by phone, please contact the national e-Referral Service appointment line: 0345 6088 888 or 0845 850 2250 for their textphone service.

NHS e-referral contact times

Monday to Friday: 8am to 8pm

Weekends and bank holidays: 8am to 4pm

e-RS appointment line: 0345 6088 888

Text phone service: 0845 850 2250

Please use the reference number and password from the patient appointment request letter, you will need to have this in front of you to book an appointment.

Key Contacts

If you have any concerns or queries about e-RS / problems finding clinics/ paper switch-off process, please contact:

Amanda Peel, Elective Access Manager
Tel: 020 8385 3058
Elective Access Management Team at

Your information

Information included in these forms is processed in line with our Patient Privacy Policy. Patient Information Data is submitted via an encrypted internet connection (HTTPS) and stored in the site database; any identifiable PID is stored encrypted in the database. The encryption key is stored outside of the root of the website. Should the referrer wish to withdraw a referral at any time, either because this was submitted in error or at the patient's request, contact should be made with the relevant team detailed on the referral form who will arrange for the information to be removed in line with the Patient Privacy Policy.