NHS e-Referral Service: How to Choose Your Hospital and Cut Waiting Times

If your GP has told you that you need to see a specialist, you may not realise that you have a say in where you are treated. The NHS e-Referral Service gives you the legal right to choose your hospital or clinic and book your first outpatient appointment at a time that suits you.

For adults over 50, this matters more than ever. With NHS waiting lists still well above pre-pandemic levels, choosing the right hospital could mean the difference between waiting six months and being seen in a matter of weeks. Whether you need a hip replacement, knee replacement, cataract surgery, or a colonoscopy, this guide is for you. It explains how the NHS e-Referral Service works and how to use it to get treated sooner.

 

 

What Is the NHS e-Referral Service?

The NHS e-Referral Service (often called e-RS) is an electronic booking system used by every GP practice in England. When your GP decides you need to see a consultant or specialist, they create a referral through e-RS rather than sending a letter or fax.

The system replaced the older “Choose and Book” service in 2015, and it now handles millions of referrals every year. It covers a wide range of services including consultant-led outpatient clinics, community health services, diagnostic tests such as scans and endoscopies, and even some mental health services.

The key benefit for you as a patient is choice. Instead of your GP simply sending you to the nearest hospital, the NHS e-Referral Service lets you see which hospitals are available, compare their waiting times, and pick the one that works best for you.

 

Your Legal Right to Choose a Hospital

Many patients do not know this, but you have a legal right to choose where you receive NHS treatment. When your GP refers you for a routine condition, they must offer you a choice of at least five suitable hospitals or clinics. This includes both NHS hospitals and private hospitals that hold NHS contracts.

According to Healthwatch, you can base your decision on several factors: travel distance, waiting times for first appointments, local support networks, patient ratings, and Care Quality Commission (CQC) inspection results. Where available, you can also choose a specific consultant-led team.

There are a few exceptions. Your right to choose does not apply if you need urgent or emergency treatment, if you are on an urgent suspected cancer pathway (the two-week-wait referral), or if you are accessing maternity services. In these cases, speed of access takes priority over choice of location.

 

You may also find our guide to cataract surgery: the facts helpful.

You may also find our guide to what to expect from your knee replacement surgery helpful.

How to Use the NHS e-Referral Service: A Step-by-Step Guide

Using the NHS e-Referral Service is straightforward, but if you have never done it before, the process can feel unfamiliar. Here is what happens at each stage.

Step 1: Your GP Creates the Referral

During your appointment, your GP enters your referral into the e-RS system. They will discuss your options and may show you the available hospitals on screen. You will receive a booking reference number and a password or access code. Keep these safe as you will need them to book your appointment.

Step 2: Choose Your Hospital

You do not have to decide on the spot. You can go home, research your options, and book when you are ready. Before choosing, check the My Planned Care website. It shows average waiting times for every hospital in England, broken down by department, and is updated weekly. A postcode search lets you compare waiting times at hospitals near you.

Step 3: Book Your Appointment

You have three ways to book:

• Online: Visit the Manage Your Referral website at nhs.uk/referrals. Enter your booking reference number and password. You will see the available hospitals and appointment slots. Select the one you prefer and confirm.
• NHS App: If you have the NHS App on your phone or tablet, you can book and manage your appointment directly through the app. This is convenient if you already use the app for prescriptions or GP services.
• By phone: Call the NHS e-Referral Service helpline on 0345 608 8888. The line is open Monday to Friday, 8am to 8pm, and weekends 8am to 4pm. An adviser will walk you through the options and book for you. This is a good option if you are not confident using the internet or prefer speaking to someone.

 

Step 4: Manage Your Appointment

Once booked, you can check, change, or cancel your appointment at any time through the Manage Your Referral website or the NHS App. If you have an NHS login, you will also receive email updates about your referral status, including triage updates and appointment confirmations.

 

Dr Chris Steele has spoken about the importance of NHS patient choice over specialists, which gives you the right to choose where you are treated.

NHS e-Referral Service: your guide to choosing a hospital and cutting waiting times

 

How the NHS e-Referral Service Helps With Common Over-50s Procedures

The NHS e-Referral Service is not limited to one type of treatment. Here is how it applies to some of the most common procedures for adults over 50.

Hip Replacement Surgery

As of 2026, the average NHS wait for a hip replacement is around 28 to 29 weeks, well above the 18-week target. Using the NHS e-Referral Service, you can compare orthopaedic departments across your region. Some hospitals have significantly shorter waits than others. For example, a smaller NHS trust or an independent hospital with an NHS contract may be able to see you weeks or even months sooner than your local teaching hospital. Read our full guide to NHS vs private hip replacement surgery for a detailed cost and waiting time comparison.

Knee Replacement Surgery

Knee replacement waiting times are similar to hip replacements, averaging 28 to 29 weeks on the NHS. When you use the e-Referral Service, ask your GP to include hospitals within a reasonable travel distance that have shorter orthopaedic waiting lists. The My Planned Care website is particularly useful here, as orthopaedic waiting times vary hugely between trusts. Our guide to knee replacement surgery costs compares NHS and private options in detail.

Cataract Surgery

Cataract surgery is one of the most commonly performed procedures in the NHS, and England has been recovering faster than many comparable countries when it comes to cataract waiting times. Even so, waits vary significantly by area. The NHS e-Referral Service allows you to choose an ophthalmology department with a shorter queue. Some independent sector providers also offer cataract surgery under NHS contracts, often with shorter waits. See our guide to cataract surgery costs in the UK for more information.

Colonoscopy and Diagnostic Procedures

If your GP refers you for a colonoscopy, endoscopy, or a diagnostic scan such as an MRI or CT, the NHS e-Referral Service applies in the same way. It is worth asking your GP about Community Diagnostic Centres (CDCs). As of 2026, the NHS has rolled out over 160 CDCs in community locations such as shopping centres and high street clinics. These often have shorter queues than major hospital radiology departments and are designed to make diagnostic tests quicker and more accessible.

 

Five Tips to Get the Most From the NHS e-Referral Service

Knowing the system exists is only half the battle. Here are practical steps to help you make the most of your right to choose.

• Check waiting times before your GP appointment. Visit My Planned Care beforehand so you can discuss specific hospitals with your GP. If you know that Hospital A has a 12-week wait for orthopaedics while Hospital B has 30 weeks, you can make a much more informed choice.
• Consider hospitals slightly further away. Travelling an extra 30 minutes could save you months of waiting. Weigh up the travel time against the potential reduction in your wait.
• Look at CQC ratings. The Care Quality Commission rates every NHS and private provider. A shorter wait is only worthwhile if the hospital maintains good standards of care. Check ratings at cqc.org.uk.
• Ask about private providers with NHS contracts. Some private hospitals, such as those run by Spire Healthcare, Nuffield Health, or Practice Plus Group, treat NHS patients at no cost to you. These often have shorter waiting lists.
• Involve a family member or friend. If you find the online system difficult, ask someone you trust to help you log in and compare options. Alternatively, call the helpline on 0345 608 8888 and they will guide you through the process.

 

Can I Choose a Different Hospital After Being Referred?

Yes. If you have already been referred and your waiting time is longer than expected, you have the right to request a transfer to a different provider. Contact your GP or the hospital’s patient services team and explain that you would like to explore alternative options.

Under NHS rules, if you are likely to wait longer than the maximum 18 weeks for non-urgent treatment, the hospital or your local Integrated Care Board (ICB) must investigate and offer you a list of suitable alternatives that can see you sooner. You do not have to simply accept the first hospital you were sent to.

If your appointment is cancelled on the day of admission for a non-clinical reason, the hospital must offer you a new date within 28 days or arrange for your treatment to be funded at another provider.

 

 

 

Whether you are facing a hip replacement, knee surgery, cataract removal, or a routine diagnostic test, the NHS e-Referral Service puts you in the driving seat. Take a few minutes to research your options before booking, and you could save yourself weeks or even months of waiting. For more guidance on weighing up NHS and private options for specific procedures, explore our guide to the most common surgeries for over-50s.

 

This article is for information only. Always consult your GP or a qualified healthcare professional before making health decisions.