Background-The COVID-19 pandemic called for significant restructuring of healthcare system in the United Kingdom to overcome the burden on emergency services and restore elective activities.This study aims to discuss the development of a new triage system of reviewing gynaecology e-referrals to secondary care and analyse the sustainability of this service beyond the pandemic.The streamlining of primary care referrals was conceptualised on the framework of Clinical Assessment Service (CAS) as recommended by NHS Long-Term Plan. Method-CAS was implemented in our gynaecology department as a response to COVID-19 pandemic.E-referrals triaged using CAS in phase 1 were reviewed and areas of improvement identified. A second review was carried out in phase 2 after implementing changes to ensure improved services.The outcomes of interest were appropriateness of referrals,destination appointments and percentage of virtual appointments. Results-185 e-referrals in phase 1 and 85 e-referrals in phase 2 were analysed.Training and education of relevant stakeholders and a more efficient CAS in phase 2 resulted in significant reduction in inappropriate referrals from 14% to 3% [RR-0.17 (95% CI - 0.04-0.72); p=0.02].For every 9 e-referral reviewed in CAS,1 inappropriate referral was avoided.The number of virtual appointments increased by 16% (45% in Group 1, 61% in Group 2). Conclusion-CAS framework provides a sustainable strategy to overcome disruptions in the provision of elective outpatient services caused by COVID-19 pandemic.It reduces inappropriate secondary care e-referrals,allows management of eligible patients digitally,shortens patient care pathway and creates a dynamic link between the primary care providers and specialist care.