6B supports healthcare organisations and digital health innovators to integrate with the NHS e-Referral Service (eRS), streamlining the referral process and enabling integrated appointment booking, advice and guidance. With our NHS e-RS integration service, you can improve referral-to-treatment times, reduce missed appointments, and provide a better experience for both patients and clinicians.
Get in touchWhether you're developing a new digital health product or extending an existing solution with NHS e-Referral Service (e-RS) API integration, 6B brings the technical expertise, healthcare insight, and experience needed to accelerate delivery.
By embedding e-RS functionality directly into your application, 6B helps you enable secure communication between providers, empower clinical decision-making, and align with NHS standards for referrals and booking workflows.
The NHS e-Referral Service (eRS) is a national digital platform that allows clinicians to electronically refer patients into specialist services and manage appointments in real time. e-RS enables secure referrals, document exchange, and two-way communication between referrers and providers, reducing the administrative burden of paper referrals and improving patient flow.
eRS is used across primary, secondary, and community care and provides features such as:
By integrating with e-RS, healthcare services can deliver faster, more transparent, and more efficient care pathways.
At 6B, we guide organisations through each phase of e-RS integration – from discovery and stakeholder engagement to development, assurance, and implementation.
In the early stages, we help your organisation assess feasibility and define integration goals. We work with commissioners to access e-RS usage data and develop a local understanding of referral behaviours. For clinical and administrative teams, we support the configuration of roles, responsibilities, and governance for using advice and guidance features.
During the planning and development phase, 6B designs integration points that align with NHS Digital’s e-RS API standards. We support technical activities like endpoint setup, authentication, and document management, while working with clinical stakeholders to shape advice and guidance workflows and define referral services.
We ensure services are listed correctly within the e-RS Directory of Services and test functionality in controlled environments before go-live. Post-implementation, we continue to provide technical and strategic support, including performance monitoring, updates, and training enablement.
Integrating your digital product with NHS e-RS allows for a more responsive, data-driven referral experience. Patients benefit from faster appointment booking and fewer delays in accessing specialist care.
For clinicians, integrated e-RS functionality reduces administrative workload, improves visibility into referral status, and enables direct advice and guidance exchanges. It also helps avoid unnecessary referrals by facilitating timely collaboration between GPs and specialists.
For commissioners and service leads, e-RS integration opens access to referral activity data – making it easier to track demand, analyse conversion rates, and drive service improvements. This creates more efficient referral pathways and ensures alignment with NHS strategic goals around digital-first care.
We have experience delivering NHS e-RS integrations across different care settings, supporting advice and guidance, booking, and document exchange functionality.
6B works closely with commissioners, service managers, and developers to ensure smooth onboarding, implementation, and long-term support of e-RS integrations.
We align integration design with NHS API standards and provide support with assurance, governance, and SCAL documentation where required.
Our development team builds modular and scalable integrations that can be reused across multiple NHS Trusts, ICBs, or clinical applications.
We bring clinical, technical, and operational expertise to every e-RS project – ensuring your integration delivers real impact and measurable service improvements.
The e-RS API supports both FHIR STU3 and FHIR R4 standards, each with its own set of capabilities and compatibility requirements. STU3 is more established, while R4 is aligned with newer NHS implementation guides. Choosing the right version for your e-RS API Integration depends on your product’s interoperability goals and the specific endpoints you need to access.
Yes, e-RS API Integration can support unattended, read-only access via application-restricted authentication using signed JWTs. This enables background services such as referral tracking or clinical reporting without requiring user interaction, ideal for operational automation in healthcare systems.
e-RS API Integration enables seamless digital Advice and Guidance exchanges between GPs and specialists, reducing unnecessary referrals and accelerating clinical decision-making. The API supports initiating, retrieving, and responding to A&G requests programmatically within your digital platform.
Yes, the e-RS API is internet-accessible and can be integrated with modern, cloud-native healthcare applications. 6B ensures secure and compliant integration that meets NHS digital security standards, whether your solution is hosted on AWS, Azure, or another cloud provider.
Timeframes vary based on complexity, but a typical e-RS API Integration project can take 8–16 weeks from discovery to live deployment. This includes planning, development, SCAL assurance, witness testing, and production onboarding with NHS England.
Security is a core requirement. e-RS API Integration must comply with NHS standards such as JWT authentication for apps, CIS2 for users, and HTTPS transport. Role and organisation validation headers are mandatory for most endpoints, and assurance processes include security and clinical safety assessments.
Absolutely. At 6B, we design modular, scalable e-RS API integrations that support multi-tenancy and can be configured for different NHS Trusts or Integrated Care Systems (ICSs), reducing development overhead and improving time-to-value.
6B provides ongoing technical support, maintenance, and feature enhancements after go-live. We monitor API updates, manage compliance changes, and offer training to ensure your e-RS API Integration remains robust and aligned with evolving NHS standards.