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Patient Care Aggregator and PEPs

The NHS Patient Care Aggregator, also known as Wayfinder, is the NHS App architecture route for giving patients a single view of secondary-care referrals and bookings. It is not a separate patient-facing app: patients access the service through the NHS App, and the NHS App displays the summary returned by the aggregator. NHS England reported in April 2026 that every acute trust was connected and 64% of hospital appointments were visible through the NHS App, although visibility remains appointment-, provider-, age- and patient-state-dependent.

Architecture Role

The Patient Care Aggregator sits between the NHS App and secondary-care booking sources:

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graph TD
  Patient["Patient"] --> NHSApp["NHS App"]
  NHSApp --> Login["NHS login"]
  NHSApp --> PCA["Patient Care Aggregator\n/ Wayfinder"]
  PCA --> ERS["e-RS"]
  PCA --> BookingSystem["Secondary care booking system"]
  BookingSystem --> PEPAppointments["PEP appointment or\nbooking function"]
  PEPAppointments --> PAS["Trust PAS / booking data"]
  PEPAppointments --> RecordService["Patient Care Aggregator\nRecord Service API"]
  NHSApp --> DeepLink["Deep link to e-RS\nor provider portal"]
  DeepLink --> PEPAppointments
  NHSApp --> ProviderRoutes["Provider portal / provider routes"]
  ProviderRoutes --> ProviderDocuments["SHC provider document route"]
  ProviderRoutes --> ProviderResults["Provider results system"]
  ProviderDocuments --> PEPDocuments["PEP document route"]
  ProviderResults --> PEPResults["PEP results-release route"]
  PEPDocuments --> DocumentSource["Provider document source"]
  PEPResults --> ReleaseControls["Clinical release controls"]
  ReleaseControls --> ResultSource["Provider results source"]
  BookingSystem -. optional .-> NHSAppAPI["NHS App API notifications"]

In the current NHS England Digital description, the NHS App asks the Patient Care Aggregator for referral and booking summaries based on NHS number. The aggregator asks e-RS and connected secondary-care booking systems for relevant summaries, returns a single list, and the NHS App shows the list to the patient. For detail, amendment, or cancellation, the patient follows a deep link to e-RS or an NHS-styled patient portal belonging to the secondary-care system. Document and results routes may also use provider portals, but they must be evidenced separately because their source systems and access controls differ from appointment summary and booking routes.

Patient Engagement Portals

In the Wayfinder context, a Patient Engagement Portal (PEP) is a secondary-care patient portal or supplier system connected to trust booking or Patient Administration System data. Patient Engagement Portals (PEPs) can return appointment data to the Patient Care Aggregator and receive deep links from the NHS App so the patient can view, book, change, or cancel appointments where the portal supports those functions. This is the PEP appointment or booking function.

NHS England also uses PEP more generally for patient engagement portals beyond Wayfinder. Results-release guidance refers to patient engagement portal (PEP) / NHS App as a digital route for releasing test results, and PIFU guidance treats NHS App, PEP, email, SMS, and hard copy as communication routes for patient-initiated follow-up. This wiki should therefore distinguish:

  • Patient Care Aggregator / Wayfinder PEPs, which are part of secondary-care referral and booking aggregation.
  • PEP appointment or booking functions, which cover appointment detail, booking, change, cancellation, and deep links where a connected appointment route supports them.
  • Secondary healthcare (SHC) provider document routes, which cover the wider route for provider-held correspondence and may or may not include a PEP document sub-route.
  • PEP document routes, which cover appointment letters, outcome letters, discharge summaries, questionnaires, forms, and other provider-held correspondence.
  • Provider results systems, which cover the wider provider-held result source and release-control context and may or may not include a PEP results-release sub-route.
  • PEP results-release routes, which cover provider-held test results and the clinical review, timing, suppression, and override controls that govern patient-facing release.
  • General PEP capability, which can include questionnaires, eForms, PIFU, or provider-specific portal functions that are not automatically NHS App-specific.
  • NHS App itself, which may display summaries and launch deep links but is not the same system as the PEP.

Granularity Rule

Use the umbrella route term when the source proves a provider-held route family but not the specific portal sub-route. Use SHC provider document route for provider-held correspondence, and provider results system for provider-held results and release-control context. Use PEP document route or PEP results-release route only where the source identifies the portal product or portal-mediated function and its NHS App display, deep-link, or access route. Collapse back to general PEP or provider-portal language where the distinction does not change confidence, cohort applicability, assurance requirements, or guidance status.

Document and Results Separation

For NHS App Adoption and Implementation, Patient Care Aggregator / Wayfinder and PEP evidence must be route-tagged before it is used in Guidance Decision Model. A connected PEP can support appointments, documents, forms, or results, but those are different evidence claims.

Route evidence Supports Does not prove DPHC decision use
Patient Care Aggregator / Wayfinder appointment summary Secondary-care referral and booking visibility through e-RS, connected booking systems, and NHS App summary display. Defence Medical Information Capability Programme (DMICP) Primary healthcare (PHC) appointment visibility, DMICP PHC appointment management, GP-filed document views, GP-filed result views, or CORTISONE publication. Use for Phase 1 SHC appointments only unless a source shows Defence Primary Healthcare (DPHC) PHC onboarding into this route.
PEP appointment or booking function Provider-portal booking, change, cancellation, or deep-link behaviour where the appointment route supports it. Test-result release, clinical correspondence, or DPHC PHC appointment management unless the same source explicitly covers that function. Keep as PEP appointment or booking function evidence; do not generalise to documents or results.
SHC provider document route Provider-held appointment letters, outcome letters, discharge summaries, questionnaires, forms, or other correspondence. GP-filed result visibility, provider results-system availability, PEP results-release, or CORTISONE-held patient data. Use as Phase 4 clinical-correspondence evidence when the provider, document type, display/deep-link route, and age/proxy behaviour are known.
PEP document route Provider-held correspondence surfaced through a PEP or NHS App-connected portal route. GP-filed result visibility, provider results-system availability, PEP results-release, or CORTISONE-held patient data. Use as a Phase 4 PEP document sub-route only when the provider, PEP product, document type, wider SHC provider document route, access route, and age/proxy behaviour are known.
Provider results system Provider-held result source and release-control context. Clinical correspondence, SHC provider document route availability, PEP document route availability, GP-filed result visibility, or CORTISONE publication. Use as Phase 5 provider results evidence only where the source identifies the provider results system and patient-facing release route.
PEP results-release route Provider-held results released through a PEP or NHS App-connected digital route. GP-filed result visibility, SHC provider document route availability, PEP document route availability, appointment management, or CORTISONE publication. Use as a Phase 5 PEP results-release sub-route only where the source identifies the provider results system, PEP product, results release, release controls, and patient-facing route.
GP-filed document or result view GP-filed documents or results surfaced through GP health-record access. Provider PEP availability or Patient Care Aggregator participation. Use on GP records pages and decision tables; for DPHC, require DPHC GP-system, Personal Demographics Service (PDS)/Organisation Data Service (ODS), supplier, release-control, and practice-capability evidence.

Integration and Assurance

A secondary-care booking system must satisfy Patient Care Aggregator onboarding and NHS App/NHS login requirements before it can surface booking data through this route. NHS England Digital guidance describes a Get Appointments API, a Record Service API that tells the aggregator which patients the booking system knows about, an NHS-styled patient portal, NHS login authentication, and NHS App integration rules including deep-link allow-listing. That evidence supports the PEP appointment or booking function only unless the same source separately documents document or results-release behaviour.

The original Wayfinder requirements specification records important implementation boundaries: referrals and appointments are sourced through the Patient Care Aggregator; e-RS and PEP systems provide remaining booking functionality; ODS is used to validate appointment specialty data; and the NHS App presents but does not store appointment information from the aggregator.

SHC provider document routes need provider, document-type, display / deep-link, authentication, age/proxy, and access-control evidence. PEP document routes additionally need the portal product and PEP document sub-route evidence. Provider results systems need result-type, source-system, clinical review, release timing, suppression, override, audit, age/proxy, and DPHC registration-effect evidence. PEP results-release routes additionally need the portal product and PEP results-release sub-route evidence. None of these routes is proven by generic provider-portal participation.

Appointment-specific notifications in this route should be separated from general NHS Notify evidence. The Patient Care Aggregator integration guide describes optional NHS App API use for patient notifications from a secondary-care booking system, while wider NHS App Notifications and Messaging integration is handled through NHS Notify onboarding.

There is no reviewed national NHS product named Appointments Reminder API. A reminder uses the NHS App API in the specific secondary-care integration or NHS Notify for wider messaging and fallback. A visible appointment summary uses Patient Care Aggregator APIs and a PEP. These are separate interfaces and assurance claims.

DPHC Relevance

For Defence Medical Command (DMedC) / DPHC continuation and/or adoption, Patient Care Aggregator evidence is strongest for secondary-care referrals and bookings, not DMICP / DPHC PHC appointment visibility or management. It may still be highly relevant for DPHC Firmbase or DPHC Overseas [DPHC(O)] patients when they have NHS secondary-care referrals or bookings that flow through e-RS, a participating trust, and a connected PEP.

For a proposed DPHC Firmbase appointment route, keep two outcomes separate:

  • reminder delivery: a DMICP appointment event/feed is transformed and submitted through NHS Notify for an NHS App message and configured fallback; and
  • appointment visibility: the source implements the Record Service and Get Appointments API relationship, NHS login and a PEP/deep-link route so the NHS App can retrieve and present a summary.

The second route is technically analogous to a connected booking system, but current public onboarding eligibility is written for eligible secondary-care trusts. It is therefore an NHS England engagement and acceptance target, not current DPHC implementation evidence.

The unresolved DPHC questions are:

  • Whether referrals from DPHC Firmbase or DPHC(O) care routes create e-RS or trust booking records visible to the Patient Care Aggregator.
  • Whether DPHC-registered adults, dependants, minors, and proxy users can authenticate through NHS login and see the relevant Wayfinder content.
  • Whether the source-reported Defence Medical Services (DMS) / DPHC NHS App appointment-booking issue concerns DMICP / DPHC PHC appointment visibility, DMICP / DPHC PHC appointment management, secondary-care Wayfinder booking, linked-profile restrictions, or another appointment route.
  • Which Patient Engagement Portal source evidence is appointment or booking function evidence, PEP document-route evidence, PEP results-release route evidence, or a general provider-portal capability, and which wider SHC provider document route or provider results system it depends on.
  • Whether Programme Cortisone affects this route directly, or only affects MOD clinical-record transfer and GP-linked functions.