Client Story
Digital referral redesign for ED mental health patients at Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust
Wrightington, Wigan and Leigh (WWL), in partnership with Greater Manchester Mental Health NHS Foundation Trust (GMMH) and the trust’s Clinical Informatics team, undertook a clinically led digital transformation of the Emergency Department (ED) mental health (MH) referral pathway. The work built on a significant service development: a co-designed Mental Health Suite opened in July 2023 adjacent to ED, created with specialist practitioners and people with lived experience to provide a safe, calming environment for rapid assessment and signposting. The programme has been recognised nationally in industry awards including the HSJ Digital Awards and the Nursing Times Awards, reflecting its impact on patient experience, safety and flow.
Faster patient flow
Referral time reduced by 95% (68 minutes to 4 minutes), surpassing the 75% reduction target ahead of February 2025.
Improved patient and staff experience
Mental health patients are now seen sooner in a dedicated, therapeutic space, improving safety, dignity, and overall experience.
Reduced operational risk
Sustained performance with backlog reduction and clearer governance, reducing errors and duplication.
Clear return on investment by releasing clinical time and reduced delays
11 WTE of nursing time released back to direct care, supporting a clear, ROI.
The challenge
Before the change, ED staff completed handwritten referral forms that were scanned and emailed to the Mental Health Team. Between December 2024 and December 2025, this process resulted in 3,200 referrals. In an environment already challenged by long triage queues and multiple electronic systems, the manual workflow was slow, prone to errors, and difficult to track. Referrals were sometimes delayed until patients were declared medically fit or Medically Optimised for Discharge (MOFD), leading to a breach of MH referral targets, and patients waiting in the main ED rather than being streamed to the dedicated MH area. These delays increased distress as well as the risk of patients absconding prior to assessment.
Objectives
The programme set a clear target: reduce ED-to-Mental Health Team referral time from arrival by 75% by February 2025 and ensure all MH patients are referred at the point of arrival. The initiative aligned to Greater Manchester’s Right Care, Right Place ambitions, the national Right Care, Right Person principles, the RCEM Side-by-Side consensus on simultaneous physical and mental health care, and the NHS Long Term Plan’s commitment to using digital technology to improve patient outcomes. Additional goals included streamlining the process, reducing impact on triage times, improving side-by-side working, and accelerating access to the MH suite.
A digitally enabled referral process
WWL introduced a digitally enabled referral process by extending the use of the Sunrise electronic patient record (EPR) platform. The new referral form auto-populates approximately 85% of patient details, routes referrals in real time to the MH inbox and replaces the previous manual scan-and-email workflow. The pathway was simplified from five steps to three, with referrals made at arrival rather than after medical clearance. This enabled earlier streaming to the MH suite and tighter coordination between ED and MH teams.
The work was nurse-led through the trust’s Digital Champions Programme, with clinical informaticians and frontline staff co-designing the workflow and safety guardrails. The team piloted the digital form in live settings, iterated based on user feedback and embedded the change with concise training and clear roles. Regular audits and rapid-cycle measurement ensured performance gains were understood, shared and sustained.
An integrated approach
Native integration with the Sunrise EPR platform ensured high data quality and reliable routing. Structured fields and auto-population reduced ambiguity and duplication, while real-time notifications supported quicker decisions. The solution was developed to be scalable across pathways, with minimal disruption to existing ED systems and workflows.
Petro Bekker, Chief Nurse Information Officer and Associate Director of Clinical Informatics at WWL, commented: “This project reflects the dedication and innovation of a team united by a shared goal: to improve the experience and outcomes for patients presenting to ED with mental health needs. The focus was on transforming the referral-to-triage process through digitisation, enabling clinicians to access vital information more quickly and make safer, more timely decisions. This has led to faster response times, reduced duplication, and a smoother pathway between services. We had the opportunity to explore how technology could truly enhance this pathway. Through close collaboration between WWL and GMMH, and with the passion of our nursing teams driving the initiative, we’ve achieved something truly impactful. The flexibility and power of the Sunrise EPR platform were invaluable—allowing rapid in-house configuration of an auto‑populating digital referral, real‑time routing and notifications, and safe integration into existing workflows—so clinicians could act faster with greater confidence. This is a fantastic example of what we can achieve when clinical insight and digital innovation come together.”
Key outcomes
Audit data demonstrates rapid and sustained impact:
- Referral time reduced by 95%, from 68 minutes to 4 minutes, surpassing the 75% reduction target ahead of February 2025. This is the time taken for ED to complete and send referrals to the MH team. Saving an hour of time for patients who may potentially be in crisis.
- Total time from arrival to be seen by a MH practitioner reduced by 70% (from 148 to 45 minutes) with the referral-to-first contact now 35 minutes, an improvement of 56%.
- Referral at arrival enabled by the EPR-integrated digital form (85% auto-populated), streamlining steps from 5 to 3 with real-time routing improving efficiency for staff.
- Fewer patients leaving before assessment and more streamed directly to the Mental Health Suite; improved patient and staff experience.
- Sustained performance with backlog reduction and clearer governance, reducing errors and duplication.
- Time saved by using the digital referral form is equivalent to having 11 full-time nurses available to do other tasks on the emergency floor.
- Alignment with GM Right Care Right Place/Right Person, RCEM Side-by-Side, and the NHS Long Term Plan.
- Established a scalable digital foundation (e.g., digital absconder log, SOS cards) for rollout across RAEI and other EDs.
Patient and staff experience
Patients are now seen sooner in a dedicated, therapeutic space that improves safety, dignity and overall experience. Staff report the process is simpler, faster and more reliable, with reduced cognitive load at triage and clearer accountability between ED and MH teams. The smoother pathway has improved confidence in early decision-making and reduced the risk of duplication and error.
The future
Building on the successful ED referral redesign, WWL plans to extend further digital efficiencies from triage through to discharge, deepen analytics on demand and flow and standardise the approach across adjacent care settings. Further enhancements will focus on proactive risk prompts to help busy clinicians take the correct action based on the trust’s protocols, structured data to support population insights and continued co-design to maintain a human-centred experience. The initiative is highly transferrable and scalable for other NHS trusts and offers a repeatable blueprint for health systems seeking rapid, measurable gains in safety, flow and experience—delivered through practical digitisation, disciplined governance and deep clinical collaboration.