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.

The PRSB has created a standard to support clear and concise information flows between the 111 referrer and the receiving services and professionals or clinicians to support safe and effective care.


ISN released: April 2023

This standard has now achieved ISN status as part of the BaRS ISN following rigorous quality assurance by the NHS Data Alliance Partnership Board. Find out more about ISN status here.

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.

The table below shows a summary view of the standard.

The blue shading indicates the sections which are included in the general practice post event message (PEM). Required means the information should be recorded or sent to the general practice where it exists.

Scope

The standard applies to:

  • All 111 and 999 service referrals to wherever the person goes next.
  • Referrals through 111 online, call handler or clinical assessment services and 999 services, and is not specific to any triage system.
  • The standard is UK-wide and developed in consultation with a wide range of professionals from all four nations, including from 111 services, receiving services, IT suppliers and people who use services.
  • All age groups including children.
 

The standard does not apply to transfers between 111 services (e.g. across a country border) or between 111 and 999 services.

Examples of the standard in use

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.

Current release

Release date: April 2023
Version: V1.0

111 referral

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GP post event message (PEM)

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Supporting documents

  • Information Standards Notice (ISN)
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    (Detailed implementation guidance specific to the sections and elements of this standard are included within the information model)
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  • Provenance data model

 
 

Implementation

The Booking and Referral Standard programme (BaRS) are running  first of type testing for NHS 111 to Emergency Department and NHS 111 to Urgent Treatment Centres (UTC) with both booking of slots in ED and 111 referral information. PRSB are supporting this and gathering feedback to improve the standard and the supporting materials.

BaRS has been approved as the strategic solution for booking and referrals and will be implemented over the next 2 years.  Further patient journeys such as NHS 111 to community pharmacy or dentistry are planned.

For more information on the standard, please see the BaRS website. This includes a list of the future patient or care journeys and technical guidance and specifications for implementation.

 

Minimum requirements

PRSB information standards define best practice based on evidence and widescale consultation and input from users and stakeholders. PRSB recognises that the NHS and social care are on a journey towards standardisation and interoperability and our aim is to support and encourage implementers on that journey.  For this reason, we have defined and clinically validated a ‘Minimum Viable Information Standard (MVIS)’ for each of our standards which represent the minimum safe instance of the standard and delivers the intended objectives within the spirit of the standard. The MVIS defines the data items and business rules which must be implemented in order to have achieved this minimum instance. It is our aim that implementers will continue to improve their implementation of the standard over time and strive for a ‘best practice’ implementation, supported and evidenced by PRSB conformance testing. Please contact our support team to receive a copy of the MVIS for this standard.


Further resources

  • IHRIM record correction guidance
    Despite vigilance when filing information in records, mistakes can occur. The Institute of Health Records and Information Management has guidance to support professionals in making corrections following errors.

Endorsement

The following key stakeholders have endorsed the standard:

  • Royal College of Emergency Medicine
  • Royal College of General Practitioners
  • Royal College of Nursing
  • Royal College of Psychiatrists
  • Royal Pharmaceutical Society
  • British Dental Association
  • Defence Medical Services
  • Urgent Health UK