Rapid improvement guide: appointment slot issues


Use this guide to minimise and manage the number of patients unable to book their first outpatient appointment through the NHS e-Referral Service (e-RS).

We've produced this guidance document in partnership with NHS England and NHS Digital. It is designed to support providers and wider health systems in managing patients who are unable to directly book their first outpatient appointment through the national e-Referral Service (e-RS).  These booking errors are known as ASIs (appointment slot issues). They result in a poor patient experience and are costly to administer.  

From October 2018, providers will be no longer paid for activity that results from referrals made other than through the NHS e-Referrals Service. It is therefore essential that you understand and address the causes and consequences of ASIs.

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