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Healthcare Professionals

e-Referral Service (e-RS) in Teledermatology

Teledermatology can be incorporated into mainstream delivery of patient care using the NHS e-Referral service (e-RS) as;

Images can be attached to e-RS Advice and Guidance requests and Referral Assessment Service referrals. 

All GP practices in England should now be using the NHS e-Referral Service (e-RS) to refer into consultant-led out-patient clinics (NHS Standard Contract since October 2018).

National Cancer Waiting Times Monitoring Dataset Guidance –Version 11.0

We would like to raise the following points from the above document:

2.5.1. Referral policy and guidance

The following are national requirements for management of two week wait referrals:

If a consultant thinks the two week wait referral is inappropriate this should be discussed with the referrer. Only the referrer can downgrade or withdraw a referral. This includes where it is considered that insufficient information has been provided.

2.5.2. NHS E-Referrals Service (E-RS

For urgent two week wait appointments, e-RS will only offer patients an appointment within the next 14 day period. If a patient cannot make themselves available for an appointment within two weeks, despite having been given appropriate information, it is technically possible for a GP or other referrer to defer making the referral until the patient is available for referral.

However, trusts should develop systems which enable a patient to choose to be seen after 14 days or the polling length set by the trust, if they are not available.

3.4.1. Communicating the diagnosis to a patient

All diagnoses of cancers should be made through direct face-to-face communication with the patient, unless otherwise explicitly agreed with the patient.

Reasonable forms of communication with patients to confirm cancer has been ruled out include:

• direct communication with the patient, over phone, Skype or similar;

• written communication by letter, or by email;

• face to face communication at an outpatient appointment.

Where a patient has expressed a preference for telephone communication, calls to confirm test results should be booked in the same way as triage appointments or outpatient appointments. Where a patient does not respond to a call, every effort should be made to contact the patient and book a new call at a different time or another date. In such a scenario the pathway should continue until the communication is made.

Where an e-mail is sent the CANCER FASTER DIAGNOSIS PATHWAY END DATE should be recorded as the email sent date.

Where a letter is sent the CANCER FASTER DIAGNOSIS PATHWAY END DATE should be recorded as the letter sent date.

Where an arrangement is made for a health care professional in primary care… to inform the patient of their diagnosis the date of this communication can only be recorded as the CANCER FASTER DIAGNOSIS PATHWAY END DATE where the secondary care provider has a clear record of this communication.

Quick NHS Reference Guides for Clinicians using e-RS for teledermatology (A&G, referral review and triage)

The following quick reference guides have been created to support Clinicians to carry out e-RS A&G and referral triage online via e-RS. 

Quick guide for clinicians reviewing Advice and Guidance Requests

Quick guide for clinicians reviewing referral Assessment service (RAS) referrals

Specimen e-RS teledermatology consent form - including patient information about teledermatology and additional consent for use of images for teaching health care professionals


e-RS features that many help organisations during the Coronavirus (COVID-19) situation


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