Triage Service (RAS) on e-Referral

Triage Service (previously called RAS)

A number of specialities have their clinics on eRS as a Triage service (previously called a RAS) in order to help triage referrals in a timely manner and to prevent patient’s attending unnecessary outpatient appointments when not required.

What is a Triage Service?

A Triage Service allows hospital trusts to:

• assess the Clinical Referral Information from the GP/referrer
• decide on the most appropriate onward clinical pathway
• contact the patient to discuss choice (if an elective referral)
• arrange an appointment, where needed
• return the triage request to the original referrer with advice, if an onward referral isn't needed

What happens with a Triage Service referral?

The Triage Service referral should be processed on eRS without going via the Referral Service. 

How do I know if a patient’s referral has been submitted via a Triage Service?

Under the ‘category’ heading on e-Ref, it will show as “Triage Request”

How will I know when the hospital has responded?

Under the ‘category’ heading, the outcomes will change to one of the following:

“Triage Response” – this means that the UBRN has been triaged and the consultant has returned this with advice as onward referral isn't needed

“Triaged – To be shortlisted” – This means the referral has been triaged and the patient has been shortlisted for an outpatient appointment. You will be able to view any triage comments from the consultant by accessing this as advised below.

Triage service referrals can be returned, in the event that the service provider feels that this is necessary. This may be because the referral needs to be redirected to another service, the provider clinician may need more information, or the patient may be suitable for treatment in primary care. Returned referrals will appear on the Rejected/Triage Response worklist with a referral status of 'Triage Response'.

 How do I view a response?

Click on the UBRN and select ‘View Request’. You will be presented with a ‘Triage Request Details’ page and the triage comments will be stated at the bottom.

Referrers can provide patients with a letter or email, if the patient is fully verified with the NHS App, detailing the service that they have been referred to and what to expect next.

FAQs

Will there be any information to give to patients who have had a request sent to a Triage Service?

Initially, there will be no printable material for a GP to give the patient when they have sent a request for triage as there are no actions for the patient to take at this point (e.g. no booking required).

It is vitally important that the referring organisation informs the patient of the situation - that their GP has sent clinical information to either a hospital or triage service, at which it will be clinically assessed and that service will either contact the patient to book an appointment or advise the GP of alternative action.

As a referrer, how do I know when to use Advice and Guidance and when to make a referral to a Triage service?

From a clinical point of view, it will depend on the intent of the referrer.

If the intention is to refer the patient, but either the referrer is not sure of the correct pathway (e.g. diagnostic test or outpatient appointment), or the local pathway is via a triage service (e.g. MSK referrals), then a triage request would be appropriate.

On the other hand, if the referrer is unsure whether the patient needs a referral at all, but just needs some clinical management advice, then the Advice and Guidance route would be preferable.

What else do GPs or practice staff need to know?

Patient’s contact details must be confirmed. This is to ensure the provider is able to contact the patient if an appointment is required.

When does the Referral to Treatment time clock start for a patient referred into a Triage service?

The RTT clock will commence from the date the triage request is received on the ‘Referrals for Review’ worklist, which will only be after the required clinical information has been attached to the request.

As a GP practice, what can I do if a patient contacts us with a query relating to a  Triage service referral?

If a patient’s referral has been sent to a triage provider service, it is then up to that provider to make contact with the patient to arrange further care, or to return the request to that GP with advice. If there has been a delay, which you or your patient consider unacceptable, then you might like to advise the patient to contact the provider. The instructions on how to find the contact details can be found in the referrer overview document, on the e-Referral website.

On the rare occasion that a provider has cancelled a patient’s booked appointment and requested a Triage service instead; when a patient tries to book an appointment online or by the National Telephone Appointment Line with their booking details, currently they may be directed back to the GP to obtain the provider information.

What should I do if my triage request made through my integrated GP system, comes back with advice and the specialty needs changing? (for example, I made a request to Gynaecology and the request is returned advising that it should have gone to a Urology service)?

Some integrated GP systems do not facilitate the changing of a specialty in a referral (as the original specialty chosen will have been coded in the patient’s record and cannot be changed). We recommend if this happens, that a new referral is created to the changing specialty to avoid confusion for the ‘new’ receiving service and to, maintain a clinically correct record in the GP clinical system.

Where can I find further information?

• NHS e-Referrals Service website

• Sign up to e-RS bulletins to receive up to date information on system changes

• Review the system Help information (N3 connection required to use this link)

• Email nhs.ers@nhs.net or use the contact us page on the eRS website to ask any questions.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.