Referrals, triage and bookings
At a glance
This workflow is a closed loop: referral or booking request, acknowledgement, triage, acceptance or rejection, appointment or return, cancellation and closure. A sent referral is not a completed referral.
Return to the Out-of-PHC row or Into-PHC row.
Scope and boundaries
Use this family for a request that another service assess, triage, book or accept a person into a pathway. A care summary sent at discharge belongs to Transfers of care and clinical correspondence; an on-demand record view belongs to Shared records, summary records and care plans.
The pathway or product name does not determine authority. Record the commissioned service, current care purpose, sender and receiver roles, exact BaRS or other published use case, referral content and all response states.
Out of primary healthcare
PHC sends only the referral and booking information necessary for the recipient to identify the person, understand the question and safely triage or provide the service. The sender must know how acknowledgement, rejection, return, cancellation and unavailability are represented and who safety-nets unanswered work.
Into primary healthcare
PHC must route acknowledgement, triage advice, appointment details, rejection, return and outcome to the correct patient and referral. Someone must own review and action, particularly where a referral is incomplete, declined, redirected, cancelled or never answered.
Candidate governing instruments
The directional matrices own the cross-workflow comparison. This page tests those candidates against the commissioned pathway, published use case and message leg; a listed instrument still applies only within its current scope.
| Layer | Workflow-specific position |
|---|---|
| Legislation | UK GDPR and DPA 2018, as amended by DUAA, apply. The Section 251B direct-care duty is conditional and does not justify unnecessary referral content. |
| Regulations and contract | The Current GP contract and regulations may govern access, referral or booking functions for the practice. Check the commissioned pathway and supplier terms. |
| Standards | The Clinical Referral Information Standard is a content ceiling without a demonstrated universal section-250 mandate. BaRS is mandatory only for its published in-scope use cases. NHS Number (ISB 0149-01), SNOMED CT, UK Core FHIR R4 (DAPB4020), DCB0129, DCB0160 and DSPT may also apply. |
| Confidentiality and other controls | Apply common-law confidentiality, Caldicott, commissioned-pathway rules, accurate recipient selection, minimum content, acknowledgement, closure, audit, correction and failure ownership. |
Minimum, conditional and higher assurance
- Required floor: a defined pathway and recipient, necessary referral content, authority and confidentiality, correct identity, a current applicable use case and safe response handling.
- Conditional envelope: disclose only information needed to answer the referral or booking question; sensitive or third-party content requires particular justification.
- Higher-assurance ceiling: structured and coded referral content with explicit state transitions, reliable correlation, closed-loop acknowledgement and a visible owner for every rejection, return or failure.
Failure states and ownership
Test wrong-service routing, duplicate referrals, missing attachments, unacknowledged work, rejected or returned referrals, booking without clinical acceptance, cancellation races, non-attendance, redirection, unavailable services and discrepancies between local and receiving-system status.
Evidence and open checks
Maintained evidence: SRC-006, SRC-007, SRC-016, SRC-017, SRC-019, SRC-020, SRC-022, SRC-026, SRC-027, SRC-040. Confirm the exact current use case, ISN and supplier path through VAL-004.
Continue with the selected referral leg
Carry one of these contexts into Decide a data flow:
- Out of PHC · Referrals, triage and bookings · Referral or booking request leg
- Into PHC · Referrals, triage and bookings · Acknowledgement, triage, booking, rejection, return or outcome leg
The decision guide tests the applicable layers before it links to the decision record. Preserve the published use case and response state.