111 Referral Standard

Across the UK, 111 services are becoming the first point of contact for urgent care and are essential in ensuring that people are referred to the most appropriate service safely and efficiently. In England the NHS Long Term Plan sets out to ensure patients get the care they need, fast and to relieve pressure on A&E departments by referring people to the most appropriate service.

This standard supports clear and concise information flows between the 111 referrer and the receiving services and professionals or clinicians to support safe and effective care.

Current release

Version: v1.0
111 Referral Standard
> Standard model – Json
> Standard model – Excel
> Standard model – PRSB viewer
GP post event message (PEM) documentation
> Standard model – Json
> Standard model – Excel
> Standard model – PRSB viewer
Supporting documentation (external NHS E Directory)

From 01 January 2026, this standard will be owned and managed by NHS England and is made available for reuse or amendment under the Open Government Licence v3.0 (OGL 3.0). A review of the ongoing requirement for this standard will be undertaken by NHS England. Details on this and any update to the standard will be published on the NHS Standards Directory. If you have any questions or feedback relating to this standard, please email: england.standards.assurance@nhs.net.

About this standard

PRSB was commissioned by NHS England to produce the 111 Referral Standard as part of the Booking and Referral Standard programme (BaRS). The standard defines the information that should be shared from 111 or 999 services when a person is referred onto another service. It also defines the information for a post event message (PEM) to inform a person’s GP of their contact with 111 services.

This is subset of the 111 referral to give GPs an effective summary, and is sent after all contacts with a few exceptions, including if the referral is to the GP, or the call was just to seek information. GPs should not confuse this PEM, which is just for their information, with a 111 referral to GP, which they must action. These will replace the current referral messages which are poorly regarded and little used.

Summary table

The standard defines the full set information which should be sent in a 111 referral, however some of the information will only be appropriate when the referral is from a clinician or the clinical assessment service (e.g., the chief clinical concern or the diagnosis).

These occurrences are noted in the implementation guidance and supported by the conformance (mandatory, required or optional) for each data item, where required means the information should be sent where it is available, recognising that this information may not be available where its not relevant to the individual case or not gathered during calls or online contact.

Much of the referral information should be generated from the system with the information recorded during the contact, with only information like the clinical summary (where used) having to be added by the referring person. This is illustrated in the examples available below.

The table here shows a summary view of the standard.

Please note: Required means the information should be recorded or sent to the general practice where it exists.

Section Name	Conformance – Mandatory, Required, Optional	Description	Included in the GP post event message (PEM)
Person demographics	Mandatory	The person’s details and contact information.	yes
Caller details	Required	Name of caller, relationship, telephone number and preferred contact method. For use where the caller isn’t the person needing care or advice.
GP practice details	Required	Details of the person’s GP practice.	yes
Dental practice details	Required	Details of the person’s usual dental practice.
Individual requirements	Required	Note that the Individual requirements section includes reasonable adjustment and specific elements for accessible information requirements to support communication.	yes
Safeguarding	Required	Any safeguarding concerns identified.	yes
Risks	Required	Any risks identified, includes risks to self or to others.	yes
Consent for information sharing	Required	This is a record of consent for information sharing under the common law duty of confidentiality. Where consent has not been obtained or sought, the reason why should be provided. Include best interests decision where person lacks capacity.
Referral details	Mandatory	Details of the referral; from where and to where and any person input into the selection. Also urgency of referral, which where the Pathways triage is used is derived from the DX code resulting from the triage process.	yes
Presenting complaints or issues	Mandatory	Presenting complaints or issues and the Chief Compliant which is mandatory. Where the Pathways triage is used the Chief Complaint is derived from the symptom group (SD) or symptom discriminator (SG) code resulting from the triage process.	yes
Problem	Required	Provides either a diagnosis or the chief clinical concern. These are only likely to be available where there has been a clinical assessment.	yes
Clinical summary	Required	A summary of the person’s contact such as reason for attendance, chief clinical concern or diagnosis and actions taken or required. Only likely to be available where there has been a clinical assessment.	yes
Social context	Required	The social setting in which the person lives, such as their household (e.g. lives alone), occupational history, and lifestyle factors.
Allergies and adverse reactions	Required	This is for person reported allergies or adverse reactions which may not be on the persons electronic health record. It is NOT to transfer the person’s recorded allergies which the receiver can look up (e.g. via SCR, GP Record or shared care record).	yes
Medications and medical devices	Required	This is for person reported medications and medical devices which may not be on the person’s electronic health record. It is NOT to transfer the person’s prescribed medications which the receiver can look up (e.g. via SCR, GP Record or shared care record). The full section has been kept for consistency even if only some of the elements are needed for this use case. This is important for example if the person is taking over the counter medications (e.g. St John’s Wort) bought online or other medications which are not on the person’s record such as mental health medications.	yes
Plan and requested actions	Required	The details of any actions or plans for the person (or carer) or the receiving professional.	yes
Person and carer concerns expectations and wishes	Required	Description of the concerns, wishes or goals of the person in relation to their care, as expressed by the person, their representative or carer. Record who has expressed these (patient or carer/ representative on behalf of the patient). Where the person lacks capacity this may include their representative’s concerns, expectations or wishes.

Examples

To give a clearer idea of how the standard works in practice, PRSB have created examples of different scenarios. Each of the clinical settings here show a view of the 111 referral, the GP post event message (PEM), and in some cases, a full model for suppliers.

111 to Primary Care