Advice and Refer (A&R) services

For routine and urgent referrals and/or advice requests to:

  • Cardiology (Heart Failure)
  • Gastroenterology
  • Nephrology
  • Neurology
  • Pain Management
  • Rheumatology

For these services, Chelsea and Westminster Hospital NHS Foundation Trust operates an Advice and Refer (A&R) pathway through e-RS.

This approach creates a single point of access for both referrals and advice requests, helping patients receive specialist advice more quickly and ensuring referrals are directed to the most appropriate service.

This process does not apply to Two Week Wait (2WW) referrals, which should continue to follow the existing cancer referral pathways.

Important information

The Advice and Refer (A&R) pathway has been introduced to create a single workflow for both advice requests and referrals.

This change does not alter our referral acceptance criteria or clinical thresholds. Requests submitted through this pathway are reviewed according to the same clinical criteria used for referrals received through existing routes.

Two screenshots of the NHS e-Referral Service (e-RS), showing ‘Advice’ selected as the request type and the subsequent ‘Make an advice request’ screen, where clinical information can be entered.How to submit an Advice and Refer request

  1. Go to the Search for a Service section within e-RS.
  2. Select Advice, then choose either Routine or Urgent, as appropriate.
  3. Select the relevant service from the list provided.
  4. Complete the Enter Advice Request box, including all relevant clinical information. If you believe the patient requires specialist assessment, please indicate within the request that a referral is being sought.
  5. Upload all relevant supporting documentation and investigation results.

Important: If you select Referral rather than Advice, these services will not be displayed.

What happens next?

A consultant from the relevant clinical team will review the request.

Following review, the consultant may:

  • Provide clinical advice to support ongoing management in primary care.
  • Request additional information.
  • Convert the request into a referral where the patient meets the relevant clinical criteria.

If a referral is progressed, patients who have provided a UK mobile telephone number will receive a text message notification directly.

Consultants will explain the rationale for their decision within their response.

We aim to respond within the national standard of five working days.