ETRIAGE · REFERRAL & ADVICE-AND-GUIDANCE TRIAGE
Every referral, triaged before the queue forms.
eTriage is Toca Health’s referral triage software for NHS secondary care. Referrals, Advice & Guidance and consultant-to-consultant requests arrive in one worklist: the letter, the attachments and the patient’s record on a single screen, with every triage action beside them. Integrated with NHS e-RS, and named in the Health Secretary’s 2026 NHS ConfedExpo keynote.
THE PROBLEM · WHERE SPECIALIST TIME ACTUALLY GOES
Specialist time is going on navigation, not on decisions.
Advice & Guidance protects outpatient capacity, and referral triage decides who waits and for how long. Both depend on a consultant having the whole picture in front of them. But that picture is scattered: the request sits in e-RS, the history sits in the EPR, and the attachments arrive as a stack of separate PDFs. Gathering it is administrative work done at consultant rates, and it happens on every single case, before any clinical judgement can begin. The answer isn’t more software. It’s one view, assembled before the clinician opens it.
THE PRODUCT
We designed a clear and simple interface.
So a consultant sees the whole case in one place, and acts on it without leaving the screen. The worklist, a referral and an Advice & Guidance conversation, as they run today.
Scroll to step through
- 01 / 06
One worklist, not four inboxes
Referrals, Advice & Guidance and consultant-to-consultant requests arrive in a single prioritised list. The counters along the top aren’t decoration, clicking one filters the worklist beneath it.
- 02 / 06
Everything you triage by, in one row
UBRN, patient, NHS number, priority, clinic type, status and who is holding it. Sortable, searchable by UBRN, and filterable to hide anything already waiting on the referrer.
- 03 / 06
The letter and every attachment, already assembled
All attachments combined into one scrollable document beside a patient banner verified against PDS. No hunting through the EPR, no zip file to download first.
- 04 / 06
The decision, and everywhere it lands
Priority, clinic type, appointment type and triage comments. Accept writes to NHS e-RS, the EPR and the document store in the same action. Reject returns it to the referrer with comments and clears it from eTriage.
- 05 / 06
Advice & Guidance as a conversation
The GP’s question and the specialist’s answer in one thread, with the record and any attachments alongside. Reply as advice, or suggest a referral.
- 06 / 06
One action turns advice into a referral
Convert to referral & accept sets priority, clinic type and comments, updates e-RS and the internal systems, and clears the item. No round trip back to the GP, no re-keying.
Illustrative screens. Patient names, addresses and NHS numbers are synthetic; NHS numbers use the reserved 999 test range.
“Up to” figures from eTriage deployments in NHS Trusts; results vary by specialty mix and pathway design. The Trust model runs these against your own published RTT position.
NHS Trusts that have transformed with Toca
WHAT IT COVERS · FOUR PATHWAYS, ONE WORKLIST
Four ways it protects capacity.
Advice & GuidanceAnswer & convert
Specialists answer the GP’s question with the full history in view, and when a clinic is the right answer, one action converts the request into an accepted referral with priority and clinic type already set. Up to 49% of A&G requests are resolved without an outpatient appointment.
Referral triageRight first time
Incoming referrals are checked against your clinical criteria and routed to the right clinic at the right priority, before the queue forms, not after. Each one locks to its reviewer, so nothing is triaged twice.
C2C & diagnosticsFaster internal pathways
Consultant-to-consultant referrals and direct-to-test requests move through the same worklist, accelerating diagnostic pathways instead of parking them in inboxes.
Written everywhereZero re-keying
Each decision updates NHS e-RS, the EPR and the document store in the same moment, and clears the case from the worklist. The audit trail writes itself.
THE DEMO · A LIVE PATHWAY, END TO END
Watch a request become a booked referral.
A walkthrough of eTriage as it runs at Royal Berkshire, from the GP’s request arriving through NHS e-RS to the decision written back to every system.
DEPLOYMENT · SPECIALITY BY SPECIALITY
Weeks to deploy. Not years.
eTriage runs alongside NHS e-RS, your EPR and your PAS rather than replacing them. Rollout goes speciality by speciality, so each clinical team goes live with criteria they have agreed themselves, and the pace stays yours. It sits on the same platform as Spectral, so one governance pack and one support route cover both.
Scope
Pick the first specialties and agree the triage criteria with your clinical leads.
Connect
We integrate with NHS e-RS and your EPR/PAS through your existing integration route. Nothing is ripped out.
Go live
The first specialties triage live cases with Toca alongside; your service desk keeps first line, we cover second and third.
Scale
Add specialties on a cadence the Trust sets, criteria-first every time.
FAQ · PROCUREMENT, IG AND CLINICAL SAFETY
The questions every Trust asks.
How long does deployment take?
First specialties are typically live within weeks of contract, not years. eTriage integrates alongside e-RS and your EPR rather than replacing anything, and rollout proceeds speciality by speciality so clinical engagement keeps pace with the technology.
What does eTriage integrate with?
NHS e-RS for referrals and Advice & Guidance, plus your EPR, PAS and document store. Where you have an integration engine and APIs, those are what we use. Where you don’t, we don’t need them, see below. It runs in the cloud, on-premise, or on sovereign UK infrastructure, your choice.
Do we need an integration engine or APIs into our EPR?
No, but we use them wherever they exist. A supported interface is always the first choice: APIs and your integration engine are cleaner, faster and easier to support, so where a system can offer one, that is what we connect to. Robotic process automation is the fallback for systems that can’t, not a substitute for integration you already have. Where we do use it, the software drives the system the way a member of staff would, signed in under a service account with permissions you set and the same audit trail any user leaves.
What if our EPR supplier can’t prioritise us?
It doesn’t block you. This is the most common reason good projects stall, so we built for it: because we can automate at the user interface layer, going live doesn’t depend on a third party’s roadmap or a change request being funded. Screens do change over time, and keeping the automation working through upgrades and reconfiguration is our job, covered by support rather than charged as a variation. If the interface you wanted arrives later, we move that connection onto it and retire the automation.
What changes for GPs?
Nothing. GPs keep working in NHS e-RS exactly as they do today. The change is on the secondary-care side, where requests arrive in one worklist with the record alongside, and answers come back faster.
Who makes the clinical decisions?
Your clinicians, always. eTriage assembles the case and carries the decision across systems; it doesn’t make the call. Where AI is used on the platform, it runs with a clinician in the loop, and Spectral, the engine behind it, is UKCA-marked as a Class I medical device.
How do we buy it?
Toca is available through G-Cloud, so most Trusts procure via a standard Call-Off Contract. We’ll support your business case with your Trust’s own published RTT position and a per-specialty model.
What about information governance?
You’ll receive a full IG pack covering hosting options, data flows and DPIA support, before anything touches a live pathway, and data stays under the Trust’s control. The detail is on the governance page.
What support do we get?
Your service desk keeps first line, as most Trusts prefer; Toca provides second and third line during UK business hours, with defined escalation routes for anything clinical-safety related.
What would eTriage release at your Trust?
Real published waiting-list data for 133 English acute trusts, and a first-pass model of what eTriage answers at the front door. Every assumption starts at your Trust’s own figures and every one of them is yours to change. The full business case takes about twenty minutes with our team.
Today, published RTT position
week 0↑ 18-week standard52+
Modelled, with eTriage at the front door
Show the workings , and the third assumption
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Waiting-list figures: NHS England RTT incomplete pathways, March 2026, published data, unmodified. The model applies an incremental advice-&-guidance deflection to new referrals, weighted by specialty amenability, nets off the specialist time spent answering, and values what’s left at your Trust’s own cost per first appointment, derived from its published activity rather than a national average. It is a first pass, not a business case: it takes no account of your specialty mix, job planning or clinic templates, which is what the twenty-minute session is for.
Put your Trust’s numbers on the table.
Start with the published RTT model, then book a demo on your own pathways, twenty minutes is usually enough.