NHS e-Referral Service

The NHS e-Referral Service (formerly Choose and Book) is a service that lets you choose your hospital or clinic and book your first appointment.

When you and your GP agree that you need an appointment, you can choose which hospital or clinic you go to. You will also be able to choose the date and time of your appointment.

What does it mean for me?

As well as giving you a choice of hospital, date and time for your appointment, NHS e-Referral Service will also give you the ability to:

  • Plan and manage around your existing appointments, if you are currently undergoing treatment
  • Fit your treatment in with your other commitments, at home and at work
  • Choose appointments that fit with your carer’s schedule
  • Check the status of your referral and to change or cancel your appointments easily over the phone or on the internet.

How does it work?

When you and your GP agree that you need an appointment with a specialist, the NHS e-Referral Service shows your GP which hospitals or clinics are available for your treatment. Your GP discusses with you the clinically appropriate options that are available for treating your medical condition.

If you know where and when you would like to be seen, you may be able to book your appointment before you leave the surgery. You will be given confirmation of the place, date and time of your appointment.

You may want more time to consider your choices. If so, you can take the Appointment Request letter away with you and book your appointment later.  Your Appointment Request letter lists your unique booking reference number, your NHS number and a list of hospital or clinic options for you to choose from. Your GP practice will also give you a password with your Appointment Request letter.

You can then decide how you wish to book your appointment; via the telephone, using the national number on the letter or via the internet.  Please note that whilst the vast majority of appointments can be booked this way, in some cases you will need to telephone your chosen hospital directly to make your appointment. This is because the hospital computer does not link to the NHS e-Referral Service. This will change over time as the old hospital computers are replaced with new ones.

Can I book all my appointments through the NHS e-Referral Service?

When you and your GP agree that you need an appointment with a specialist, you can book your first hospital or clinic appointment using the NHS e-Referral Service.

The benefits of Choose and Book:

  • You can choose any hospital in England funded by the NHS (this includes NHS hospitals and some independent hospitals).More information about hospitals is available on the NHS Choices website.
  • You can choose the date and time of your appointment.
  • You experience greater convenience and certainty. With the NHS e-Referral Service, the choice is yours.
  • There is less chance that information will get lost in the post because more correspondence takes place through computers.

Choosing your hospital

Most patients now have the right to choose which hospital provider they are referred to by their GP. This legal right, which was introduced in April 2009, lets patients choose from any hospital provider in England offering a suitable treatment that meets NHS standards and costs.

Patients can choose which hospital they are seen in according to what matters most to them, whether it’s location, waiting times, reputation, clinical performance, visiting policies, parking facilities or other patients’ comments.

A choice of hospital is available for most patients and in most circumstances. Exceptions include emergency and urgent services, cancer, maternity and mental health services. If you need to be seen urgently by a specialist (for example, if you have severe chest pain), your GP will send you where you’ll be seen most quickly.

Can I choose which consultant I see?

NHS Your ChoiceA patient has a legal right to be able to choose which hospital they are referred to for their first outpatient appointment, but not a legal right to specify which consultant they see.

If it is thought that a specific consultant is the most clinically appropriate person to treat your condition, your GP/referrer can clearly indicate in the referral letter or refer you to a named consultant providing the hospital has made them available to be selected through the NHS e-Referral Service. Otherwise, you will be referred to a department and may or may not be seen by that specific consultant.

Will the NHS e-Referral Service make getting an appointment faster?

Yes. The old process is that your GP writes a letter and the hospital allocates a date and time for your appointment. This could take several weeks and the date and time offered may or may not suit you.

In some cases it will allow you to book your first hospital appointment immediately and electronically while you are still at the GP surgery, so that you can go home with a definite and convenient appointment in your hand.

If you are unable to make a decision in your GP surgery.  If for example, you need to check with your family, friends or work before booking your appointment, you can do it later over the phone or on the internet.

Will it reduce my waiting time?

Since December 2008, the longest you should wait after being referred by your GP until you start your treatment is 18 weeks – that is, unless you choose to delay treatment or there is a clinical reason why you should wait longer. Wherever possible, you will wait less than this, with the average wait being around eight weeks. This means that any hospital appointments, tests, scans or other procedures that you may need before being treated will all happen within this maximum time limit.

Choose and Book will offer you a list of hospitals to choose from, together with a range of available appointment dates and times.  You can then decide to go to a particular hospital even if it means you will have to wait longer, or to have an earlier appointment at another hospital.

Information about waiting times at different hospitals is available on the NHS Choices website. You can also call The Appointments Line on 0345 60 88888 (open between 7am and 10pm every day, all calls will be charged at local rate).

How long is the average waiting time in my area before I can see a specialist?

Appointment waiting times for your area can be found the NHS Choices website, where you can search by both hospital and specialty.

Do I have to pay to go privately if I want to be seen more quickly and the NHS e-Referral Service is not available in my area?

Some private hospitals provide services to the NHS nationally and some Primary Care Trusts also have local agreements with private hospital providers.  Those services can be found via Choose and Book.  However, if you choose to be treated outside of the NHS, the arrangements for private healthcare are the same as they exist currently.

Please contact your local Primary Care Trust to discuss your options and their plans for supporting patient choice.  Contact details are listed on the NHS Choices website.

What happens if my condition worsens dramatically before I get to see a specialist?

If you feel your condition has deteriorated and are concerned, you should return to your GP.


Page updated: 14 February, 2022