NHS e-Referral Service (e-RS) major incident update

14 January 2026

The NHS e-Referral Service (e-RS) has been experiencing ongoing performance issues. NHS England technical teams are continuing to investigate this as a major incident. The issues are affecting the e-RS backend database and may result in:

  • system slowness
  • error messages
  • difficulty or inability to log in, including via smart card.

Technical teams are working to identify the root cause and are putting mitigation measures in place to keep the service running. Users are receiving updates via in-system pop-up messages and incident management communications. 

Practices may wish to implement additional checks and proactively monitor worklists to ensure referrals are successfully transmitted and actioned, particularly suspected cancer referrals and other urgent items such as rapid access chest pain clinic referrals.

If you are experiencing issues within e-RS, please report them directly using the “help within the e-RS system” link in the top-right corner of each screen.

A letter (PDF) contains further details.

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