An NHS trust in north-east England has achieved the health service’s target of operating a paperless system for hospital referrals, with 100% of appointments now being booked online.

County Durham and Darlington NHS Foundation Trust first adopted the NHS’s e-referral system (eRS) 10 years ago. Until recently, about 80% of the 8,000 referrals GPs make to the trust’s hospitals each month were made online – ahead of the current NHS-wide utilisation rate of 70%.

The NHS is in the process of “a paper switch off” programme, and requires GPs to make all secondary-care referrals via the eRS system by 1 October. From that date onwards, providers will not be paid for appointments that are not booked electronically.

More than five months ahead of schedule, County Durham and Darlington has joined the growing band of trusts to achieve a 100% utilisation rate for e-referrals. In recent weeks, the trust has worked with NHS Digital to negotiate the final stages of its journey towards going paperless.

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The trust’s patient booking manager Margaret Herkes said: “We liaised with local GPs to understand why they did not always refer through the e-RS. There were two main reasons: one was that not all hospital consultants were named on the e-RS, so they had to send a paper referral if they wanted a specific clinician; the other was that GPs could not refer through e-RS if they only wanted advice, not an appointment.”

During the paper switch off, County Durham and Darlington also worked with software firm EMIS Health. The trust’s hospital-patient-administration system runs on the IT firm’s CaMIS technology.

As of early last month, NHS Digital claimed that 16 trusts had gone fully paperless, with the same amount predicted to do so by the end of March. 

Across England there are almost 7,500 GP practices. Doctors as these practices refer patients to clinicians at more than 220 NHS trusts nationwide, as well as upwards of 850 other commercial and third-sector organisations that provide secondary care to NHS patients.

The 70% utilisation rate achieved in NHS Digital’s latest weekly report represents an increase on the 62% rate at which eRS began 2018. This, in itself, was a marked rise on the 54% level at which usage has remained fairly static for the past few years.