Referral outcomes
0 converted to service users
0 lost / rejected
0% conversion rate
period to date · feeds the Referral report (P-004)
Referrals › REF-2026-0061
- Received
- In review
- Validated
- Converted
Item 6.10: opening a referral locks it to other users (a padlock shows against it in the list) and moves its status to In review. It unlocks when you leave, when it is reassigned, or when someone with the unlock-referral privilege releases it (item 9).
Possible match – existing agreement at this address. R-005
Service user already at 12 Mill Lane, Leeds LS4 2AB: Carter, Mrs Edith · 000061234 Active agreement. Margaret may be a second occupant sharing the equipment.
Deactivated agreement at this address. S-008 R-005
A service agreement at 12 Mill Lane, Leeds LS4 2AB was deactivated on 14 Feb 2024: Carter, Mr Walter · 000058902 Deactivated reason: service user deceased. Check whether equipment was recovered before installing.
Prospect details
No client photo – captured at conversion against the monitored organisation (S-002)NameMrs Margaret Carter
Known asPeggy
Date of birth14 Mar 1939 (87)
Telephone0113 296 0614
Second telephone07700 900614
Self referralNo – referred by hospital
Address12 Mill Lane, Leeds LS4 2AB
Risk assessment
Connect assessment – completed at conversion, not on the referral formThe old Quick Agreement combined a referral and a risk assessment in one step; it is removed – this is a simpler referral form. G-006 The Connect risk assessment is completed when the referral is converted; a request cannot complete until its assessment is published. S-016
StatusNot started – begins on conversion
Referral history
State changes + days in each state (old SM "Referral History")| State | Changed on | Days | Changed by |
|---|---|---|---|
| Received – created from hospital discharge form | 17 Jun 2026 08:40 | 0 | St James's discharge team |
Details
EditSourceHospital discharge R-007
OrganisationSt James's University Hospital (External) R-004
ReferrerS. Okonkwo · Discharge coordinator
Phone / email0113 206 5000 · discharge@sjuh.nhs.uk
Referral date17 Jun 2026
Referral causeDischarge from hospital – falls risk
Handler– unassigned – Q-005
Attachments
Word, PDF or image filesAttachments are carried onto the service agreement when the referral is converted, and are visible in the audit trail (who attached what, when).
Referrals › Templates & surveys
Back to referrals
Referral templates & surveys
Default referral forms combine the NSM form with the old SM form, with "pick stock" removed (R-001). R-001 Each template can be published as a public page with an obscure URL so third parties can fill it in; the requester's name is compulsory. R-002 Different sources cover Public, GP, Hospital discharge and Social Services, with electronic imports from web/email/MS Forms. R-007 Template configuration lives in Administration; this page lists the active templates and their public links.
Active templates
| Template | Source | Public link | Fields | Actions |
|---|
Pencil = edit the template (name, source, fields, publishing). Form icon = use the template to key in a referral. Copy = the public survey link. Template configuration is mirrored in Administration; this page is where the intake team works with them.
External survey links
Saved in the system; published to an obscure URL (R-002)Published surveys can be filled in by third parties (GPs, hospital discharge teams, the public). Submissions arrive here as new referrals; electronic requests can also be imported from websites, email and MS Forms. R-007
https://referrals.ilosplatform.com/s/9f3a8c21-7e4b-discharge
Greg Mason to provide sample referrals for each source R-004