East Lancashire Hospitals NHS Trust

Patients benefit from faster GP referrals with RPA at East Lancashire Hospitals NHS Trust 


East Lancashire Hospitals NHS Trust (ELHT) is accelerating patient pathways by applying Robotic Process Automation (RPA) alongside the national GP referrals system – saving almost one million sheets of paper per year, whilst freeing up time to provide better patient experience.

Streamlining its referral process was critical as the Trust provides healthcare services to a population of around 530,000 residents - accounting for over a third of total Lancashire regions. Its services span over 22 different sites, including 5 hospitals. Within them, ELHT care for almost 700,000 patients on average each year - making secure, efficient, and effective referral handling essential.

The Challenge

NHS Digital launched a new electronic referral system, as part of its continued paperless initiative. Named e-RS, this new system allows GPs to refer patients digitally for consultations, tests, and appointments within hospitals and other secondary care services. It also aids in the integration of NHS Spine – a national network of patient records, allowing Trusts across the country to access all the information necessary for effective patient care.

Initially the Trusts referrals process was largely manual - clinicians and clerks were required to retrieve and print the GP’s letter from e-RS, ahead of patient appointments. ELHT identified several issues with this process, before aspiring to achieve a more streamlined approach:

  • Admin burden: The original process required a lot of human intervention, taking up valuable working time for healthcare professionals.
  • Paper wastage: Even with a digital platform, this process involved large quantities of paper. The Trust endeavours to reduce its environmental impact wherever possible.
  • GDPR & data loss risks: As with all physical records, there was GDPR and data security concerns, especially due to the sensitive nature of patient records. Paper referrals including patient details could easily be lost or taken.
  • Costs: This process required ample printing and manual processing.

The Solution

EHLT has successfully utilised NDL Automate since 2012 and has already benefited from RPA in many different departments - such as Pathology, Accident and Emergency, Outpatients and more.

Due to this previous experience, the Trust was able to quickly refine their referral process with NDL’s low-code platform, and their existing licence. However, as the pressures of the COVID-19 pandemic mounted, EHLT reached out to NDL’s Professional Services team for support with the project. This enabled a new solution to be crafted and delivered in a matter of days.

The rule-based nature of the process allowed for the complete removal of human intervention in the referral process. Bots were able to completely emulate the repetitive admin tasks within e-RS - including the verification of patient information against NHS Spine data, and the transferal of referral documents to a specified file location.

Records are then accessible on the clinical portal, enabling clinicians to view the referral letter electronically, rather than relying on a printed copy. Patient records can then be seen well in advance of clinical appointments, enabling for better preparation, prioritising, and patient experience. The bots continue to process around 15,000 e-referrals per month, which has reduced a large administrative load for the Trust.

The Benefits

The Trust has experienced many benefits from this fully automated, digital process - including a significant reduction in the time spent on repetitive administrative tasks, less paperwork, and faster referrals for patients. Most importantly, clinicians can now dedicate more time to their patients, providing better care and patient experience.

  • Improved patient experience
  • Clinicians no longer process 15,000 referrals per month
  • Freeing up time that equates to two and a half FTEs
  • Enhanced patient data quality and security
  • Eradicating monthly costs of approx. 83,000 sheets of paper
“Since implementing this new system, we have been able to improve the flow through clinics as a whole. Clinicians are no longer wasting time looking for information and the feedback has been extremely positive. It has allowed different specialities to prepare for their clinics well in advance of the appointment.”
Sue Elliston - Directorate Manager, Centralised Outpatients and Administration Services.

What’s next?

As the Trust continues to move towards a full Electronic Patient Record (EPR) system, RPA has been identified as a key tool to support this transition, whilst still utilising RPA in key service areas such as A&E and Pathology. ELHT continues to lead the way as an RPA exemplar in the NHS – setting a high standard for digital transformation in healthcare. For more digital inspiration, look at our other Success Stories or contact a member of our team.


Page image attribution - liz dawson / Entrance to new Royal Blackburn Hospital / CC BY-SA 2.0


 “The support from NDL throughout the project has been really good. I only have to call, and I get the support I need straightaway.  We now have the NDL RPA platform working across multiple processes - it’s been a long-term commitment for us”.

Carl Fairclough – ELHT Performance Head of Systems Support