Are digital referrals improving patient experience in Kent?
Healthwatch Kent has published a new report examining whether the Electronic Referral Optimisation System (EROS) is delivering meaningful improvements for patients referred from their GP to hospital services.
EROS was introduced by the Kent and Medway Integrated Care Board in 2023 as part of a wider move towards digitising NHS services. The system is designed to streamline referrals, reduce waiting times, improve communication, and give patients greater choice and control over their care.
Two years on, Healthwatch Kent returned to hospital sites across the county to hear directly from patients about their experiences.
EROS was introduced by the Kent and Medway Integrated Care Board in 2023 as part of a wider move towards digitising NHS services. The system is designed to streamline referrals, reduce waiting times, improve communication, and give patients greater choice and control over their care.
Two years on, Healthwatch Kent returned to hospital sites across the county to hear directly from patients about their experiences.
Listening to patients before and after EROS
To understand the impact of EROS, Healthwatch Kent compared feedback from patients before and after the system was introduced. In November 2023, we spoke to 104 patients attending Ear, Nose and Throat (ENT), Trauma and Orthopaedic (T&O) and Musculoskeletal (MSK) appointments across six Kent hospitals. In April 2025, we revisited hospitals and gathered the same feedback from a further 106 patients using the new system.
By asking the same questions both before and after implementation, we were able to explore what – if anything – had changed for patients navigating the referral process.
What has improved
The findings show some positive shifts since the introduction of EROS.
Patient satisfaction has increased, with more people rating their referral experience very highly following implementation. There were also small reductions in the number of patients needing to repeatedly chase their appointment by phone, suggesting some improvements in how referrals are managed behind the scenes.
Communication around appointment delays has also improved for some patients. While fewer people were aware that their appointment had been delayed, those who were aware were more likely to understand the reason why. There was also a reduction in the number of patients waiting more than five months to receive an appointment letter.
Encouragingly, more patients told us that their communication needs were being met, including people who require reasonable adjustments.
Areas where patients still face challenges
Despite these improvements, many aspects of patient experience remain largely unchanged.
Patients were no more likely to be given a choice of hospital location after EROS was introduced, a recurring concern highlighted both before and after implementation. Several people also described appointments being moved to less accessible hospitals, creating additional challenges around transport and travel.
Waiting times continue to be a significant issue. Some patients described long delays that affected their wellbeing, particularly those experiencing pain or worsening symptoms. Others reported confusion caused by cancelled or rearranged appointments, missing letters, or the need to navigate multiple departments to get clear information.
The report concludes that while EROS has contributed to modest improvements, digitising referrals alone does not resolve wider pressures within the system. Clear communication, patient choice and consistent updates remain critical to a positive experience.
Why this matters
Digital systems are increasingly central to how people access NHS services. As these systems continue to expand, it is vital that patient experience keeps pace with technological change.
This research adds an important patient voice to local discussions about digital transformation, highlighting both the potential benefits and the areas that still need attention.
Healthwatch Kent will use the findings to support conversations with the NHS and other decision-makers, ensuring patient experiences continue to shape how referral systems develop in the future.
Read the full report
Our full report, Effectiveness of the Electronic Referral Optimisation System, includes detailed findings, patient quotes, and recommendations for further improvement.
👉 Read the full report and find out more about what patients told us
Read the full report
Our full report, Effectiveness of the Electronic Referral Optimisation System, includes detailed findings, patient quotes, and recommendations for further improvement.
Effectiveness of the Electronic Referral Optimisation System
