NHS England has set aside £55 million to reward GPs and hospitals to increase the uptake of electronic referrals to 100% by 2018.

Around half of all patients are currently referred for hospital appointments electronically using the new NHS e-Referral Service.  NHS England wants to see this increase to 60% by this September, 80% by 2017 and 100% by 2018.

Planning guidance released by the national commissioning board in December 2012 set the target of paperless referrals by March 2015, but this date was later pushed back by three years. 

In 2018, NHS England and NHS Improvement will also consult on whether the requirement to complete and process referrals electronically becomes a condition of the national tariff, meaning that commissioners and providers would no longer be paid for referrals made by paper.   

Director of digital technology Beverley Bryant said: “For a long time, our first class healthcare system has been let down by outmoded systems, where patients are referred to hospital by second class post.  

“We have a duty of care that extends beyond providing effective treatments.  We must also provide an effective patient experience that ensures patients feel reassured at a time when they are most vulnerable.”

The £55 million will be released through the 2016-17 Quality Premium, a scheme designed to reward clinical commissioning groups for improvements in quality of services. They can use it to support GPs and hospitals to adopt electronic referrals.

There will also be payments for hospitals to adopt the practice of processing e-referrals next year through a 2017-18 Commissioning for Quality and Innovation initiative.    

The new e-Referral Service has been developed inhouse by the Health and Social  Care Information Centre working with BJSS and went live in June 2015, replacing the old Choose and Book service.

The launch was beset by “technical difficulties” including several periods when it was unavailable. Bryant said last November that the service was now stable and “fit for purpose” and Digital Health News has reported that it is back up to processing 40,000 referrals a day. 

Choose and Book went live in 2004, after the then-Labour government promised to introduce “airline-style booking” to the NHS.

The Department of Health set a target of 90% of hospital referrals to be made via the system by 2007 and GP funding was attached to using the system. Usage hit a high of 57% in March 2009, but declined when the GP funding ended and remained stalled at around 50%.

Research by the National Audit Office suggests the NHS could save £51 million a year if every referral was made online.