13 November 2026

How to refer patients during the Microsoft outage

Referrals Workforce 2026

We know members are concerned about how to refer patients while systems are affected. Use a risk-based approach. This guidance applies only where your usual referral route has been affected by the outage.

Your local health system may put contingency arrangements in place during the outage. Where it does, follow its advice, as this takes priority over the general approach set out here.

Emergency referrals

Send the patient to emergency eye care or A&E. Give them a copy of the referral so the hospital knows the reason for referral and your concerns. In line with College guidance, call ahead where possible.

Urgent referrals (patient needs to be seen within one week)

You can delay sending the referral for a short time while systems recover. If it can’t be sent by the end of the next working day, use another route, such as phoning the receiving eye unit or using another secure method agreed locally. When the referral is sent, state clearly that it was delayed by the system outage.

Tell the patient that their referral may be delayed. Make sure they know what to do and who to contact if their symptoms change or get worse.

Routine referrals

You can wait until the outage is resolved before sending these. Keep a secure log of every referral waiting to be sent. Record:

  • The patient
  • The date seen
  • The urgency
  • Where the referral is going
  • How it will be sent
  • Who is responsible for sending it

Don’t rely on a system that may itself be affected. Urgent referrals need particular care: it should be clear who will send each one and when. This matters most in practices with locum or part-time staff. Make sure someone who will be in the practice owns the log, so no referral depends on a clinician who isn’t working when systems come back.

If systems have not been restored by Monday 16 November, we will issue further advice. (Issued by The College of Optometrists, AOP, FODO and ABDO)

Find out more

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