referral guidance - guildford and waverley ccg · referrals should be made on the standard form...

Referral Guidance

A & E

GPs are strongly requested to contact the specialty teams DIRECTLY WHEN

APPROPRIATE to avoid unnecessary delays for their patients in A & E. Relevant

non-urgent conditions can be given an early A & E clinic appointment to see a

consultant. If the surgery contacts the department, an appointment time will be given

over the telephone on 01332 347141 ext 2170. The patient may then present with a

letter at the appropriate time and will be booked in for their appointment.

AUDIOLOGY

DIRECT REFERRAL SERVICE FOR THE ELDERLY DEAF

The Direct Referral Service is specifically designed for those patients with simple

age-related sensorineural deafness, who meet the referral criteria (see below). Initial

assessments are undertaken by Senior Audiologists and include a case history,

otological examination and an audiological evaluation.

Patients meeting a second set of criteria then have an aural impression taken and are

subsequently fitted with a hearing aid. Those not meeting this criteria are referred on

to the ENT department for a medical opinion.

Referrals

Referrals should be made on the standard form contained within the Direct Referral

Information Booklet (available from this department) together with a referral letter

routinely used by the GP practice. Referrals should be sent directly to the Audiology

Department. Please provide the necessary information for patients requiring

transport.

Referral Criteria

There is an agreed GP protocol for the direct referral of the elderly deaf requiring

hearing aids:

1. Patients should be 60 years of age or over

2. Patients should be examined by their GP:

- wax should be removed from both ears as and when necessary

- examination should reveal normal eardrums

3. Patients should show no evidence of:

- sudden onset of deafness

- history/signs of active discharge from either ear

- otalgia affecting either ear

- vertigo

- previous ear surgery

- fluctuating hearing loss (not associated with the common cold)

- continued tinnitus

- any other unusual presenting feature, ENT or hearing abnormality

Audiology Referrals

Patients with hearing problems should be referred either to ENT or the Audiology

Department in the usual manner. If a hearing aid is prescribed, patients can choose to

purchase a private aid, in addition to, or in place of the NHS aid.

Patients wishing to specifically use the private service many contact the department

directly, without any referral from the GP. However, if certain medical conditions

were found to be present, patients would be referred back to their GP.

NB: This service is available at the Audiology Department or in the patient’s own

home for those people not physically able to get to the hospital.

CARDIOLOGY

Outpatient Referrals

Referrals should be made using the standard letter (see preferred example referral

letter) and sent to the Health Records department of the appropriate site marked with

the degree of urgency.

CLINICAL HAEMATOLOGY

Referrals

Patients can be referred by letter, fax or telephone to the consultant’s secretary.

Emergency admissions to the ward can be arranged by discussion with the consultant

or registrar.

Existing patients are able to refer themselves to the clinic or day ward if necessary.

The senior medical team provide 24-hour cover for haematology patients and for

advice to colleagues. They can be contacted out of hours via the DRI switchboard on

(01332) 347141.

Anticoagulant Referrals

Contact Sister Salinder Gill or Sister Kate Welch on (01332) 347141 ext 2796 or

(01332) 254770 Monday to Friday between 8.45am and 5.00pm. Alternatively they

can be contacted via bleeps 3427 / 3426.

CLINICAL ONCOLOGY

Referrals

Patients can be referred by letter or telephone to the consultants secretary.

Emergency admission to the ward can be arranged by discussion with the consultant

or Ward 17 SHO’s.

Existing chemotherapy patients are able to refer themselves to the clinic or ward if

necessary.

DERBYSHIRE CHILDRENS HOSPITAL

Referrals

Routine Referral for Consultants

To be addressed to the New Referrals Department, Derbyshire Children’s Hospital,

Uttoxeter Road, Derby.

Urgent Referrals

For outpatient appointments telephone 01332 625654 or 340131 ext 6805. Urgent

referrals can be faxed to 01332 625629.

Emergency Referrals

Ring 01332 340131 and ask for first, on-call for paediatric medical referrals or

second, on-call for paediatric surgical referrals.

Direct Access Referrals

Physiotherapy

Specialist Paediatric Physiotherapy services are not available elsewhere in Derby on

Direct Access. Services are available Monday to Friday, 8.00am – 12.00pm and

1.00pm – 4.00pm. Direct dial telephone number 01332 625539.

Psychology

Services are available Monday – Friday, 9.00am – 5.00pm. This applies to both the

Children’s Hospital and the Ronnie MacKeith Centre. Referrals are to be addressed

to Sue Rhead, Director of Clinical Psychology.

X-Ray

Services available:

Monday and Wednesday 9.30am – 12.00pm and

2.00pm – 4.00pm

Thursday 9.30am – 12.00pm

Friday 2.00pm – 4.00pm

Direct dial telephone number 01332 625540.

Orthoptic Services

Secondary orthoptic screening service is provided for 0 – 8 year olds. Primary

orthoptic screening service for children aged 3 – 4 years old is provided in the

community in partnership with Child Health Services

Audiology

Community Audiology Services can be contacted on 01332 625663.

DERMATOLOGY

Referrals

Outpatient


letter) and sent to the Health Records department marked with the degree of urgency.

For adult referrals please send to the DRI, for children’s referrals send to the Health

Records department at the Children’s Hospital.

Suspected Skin Cancers

Suspected skin cancer referrals (Melanoma and SCC) should be made using the

standard letter contained in the ‘Referral Guidelines for Suspected Cancer’ and faxed

to the department

DIABETES



letter) and sent to either the Health Records department at the DRI (medical

outpatients referrals) or the Jenny O’Neill Centre (Diabetes referrals) marked with the

degree of urgency.

The following specialist clinics can be accessed via routine clinics held in the

Diabetes Unit: erectile dysfunction, painful neuropathy (acupuncture), nephropathy,

ante-natal, nurse-led pump clinic, tablets to insulin groups, clinical psychology, sensor

clinic, low calorie diet clinic, elderly clinic.

Urgent Referrals (eg newly diagnoses young patients likely to need insulin) should be made by telephone to the Diabetes Unit or one of the consultants’ secretaries.

ENT

Referrals


letter) and sent to the Health Records Department at the DRI marked with a degree of

urgency.

If you wish to discuss an urgent case you can contact the doctor on-call. For any

information relating to a patient’s appointment contact the nursing staff or the medical

secretaries.

GASTROENTEROLOGY



letter) and sent to the Health Records Department of the appropriate site marked with

a degree of urgency.

Very urgent requests should be telephoned to the consultant secretary or by the 2-

week cancer route if appropriate.

GENERAL SURGERY

Referrals

Routine Referrals

Outpatient referrals should be made using the standard letter (see preferred example

referral letter) and sent to the Health Records department of the appropriate site

marked with the degree of urgency. Please refer to ‘Clinic Schedules’ below for

correct site.

Urgent Referrals

For emergency or urgent outpatient clinic referrals, the consultants should be

contacted through their secretaries on the numbers shown above.

Breast Surgery Referrals

Regular Radiological and Surgical outpatient clinics are held at the Breast Unit for

symptomatic breast referrals. Referrals should be made by letter directly to the Breast

Unit and not to General Surgery. All referrals for patients which are deemed

clinically urgent should be faxed directly to the Breast Unit (Fax: 01332 298719).

GUM

Referrals

Patients may self-refer by using the ‘Walk In’ service between 9.00am – 10.00am

Monday to Friday, or 2.00pm – 3.00pm Monday and Thursday.

Referrals should be made using the standard form and sent direct to the clinic at the

Derbyshire Royal Infirmary.

Cross referrals are made to and from Gynaecology, Haematology and other

specialties.

IMAGING

Referrals

Plain Film Radiography

Appointment not necessary, patients should present to :

X-Ray 1 DRI 9.00am – 12.00pm

2.00pm – 4.30pm

Monday – Friday only

Main X-Ray DCGH 9.00am – 12.00pm

2.00pm – 4.30pm

Monday – Friday only

Children’s X-Ray 9.00am – 12.00pm

2.00pm – 4.30pm

Monday, Wednesday, Thursday and Friday only

All patients must have an appropriately completed and signed request form, giving sufficient relevant clinical information as to justify the examination.

Ultrasound Examinations

General Ultrasound Examinations

Appointments are required for Ultrasound examinations. Request forms should be

sent direct to the Ultrasound Department at either the DRI or DCGH site. Patients

will be notified with a suitable appointment time. Requests for clinically urgent

examinations should be telephoned to either Ultrasound Department:

DRI 01332 254721 DCGH 01332 625518

All patients must have an appropriately completed and signed request form, giving

sufficient clinical information to justify the examination.

Obstetric Ultrasound

1st Trimester: confirmation, viability & dating scans, up to 18 weeks

Appointments are required for these examinations. Appointments can be booked

directly by telephone by referring clinician or midwife (01332 625736), or by sending

a request form. All patients must have an appropriately completed and signed request

form, giving sufficient clinical information to justify the examination.

2nd

& 3rd

Trimester – 18 week to term

Appointments are required for these examinations. Appointments can be booked

directly by telephone by referring clinician or midwife (01332 625674), or by sending

a request form. All patients must have an appropriately completed and signed request

form, giving sufficient clinical information to justify the examination.

GI and other Contrast Examinations

Appointments are required for these examinations. Request forms should be sent

direct to X-Ray 2 at the DRI or main X-ray at DCGH. Patients will be notified of a

suitable appointment time. Requests for clinically urgent examinations should be

telephoned to:

DRI 01332 254838 DCGH 01332 625519

Bone Densitometry


direct to Bone Densitometry, Main X-Ray at DCGH. Patients will be notified of a

suitable appointment time.

CT Examinations


direct to CT Department at the DRI, or Main X-Ray at DCGH. Patients will be

notified of a suitable appointment time.

BREAST CANCER REFERRALS

Urgent suspected Breast Cancer referrals should be faxed on the correct Derby Cancer

Centre referral form, direct to the Breast Unit on 01332 298719. These cases are seen

within 14 days.

Guidelines for urgent referrals include:

New lump – especially age greater than 30 years Dimpling or distortion or changes in the shape of the breast Nipple retraction

Routine non-urgent requests – GPs should refer by letter, direct to the Breast Unit.

These referrals are usually seen within 4 weeks.

Family History referrals – these should be made on the FHGP referral form and can

then be acted upon appropriately.

KINGS LODGE

Referrals

Medical Consultants, General Practitioners and Health Professionals can make

referrals for elective admissions and/or assessment of needs either by phone or in

writing.

MEDICINE FOR THE ELDERLY

Outpatient and Domiciliary Referrals

Letters must state if ambulance transport is required and indicate if an escort will be

in attendance.

Derbyshire Royal Infirmary Referrals


letter) and sent to the Department of Medicine for the Elderly, Bed Bureau, DRI.

Letters may be named or un-named and should indicate urgent or non-urgent. Urgent

referrals to the DRI consultants can also be telephoned / faxed via Bed Bureau.

Derby City General Hospital


letter) and sent to the Health Records department, DCGH.

For urgent referrals to DCGH, please telephone the consultant’s secretary.

Community Hospital Clinics


letter) and sent to the individual hospitals concerned.

Day Hospital Referrals

Please use the same system as for outpatient referrals.

NEUROLOGY / NEUROSURGERY



urgency. Very urgent requests should be telephoned to the consultant secretary.

NUTRITION AND DIETETIC SERVICES

Referrals should be made using either the dietetic referral form or by letter. All

referrals must be completed with patient details including medical condition and

signed by a registered medical practitioner.

Across the two sites, there are general dietetic outpatient clinics held at specific times

on

NUTRITION TEAM SERVICES

Referrals should be made in writing, including patient details, medical condition and

reason for referral and sent to the Dietetic or Nutrition department. A registered

medical practitioner should sign all referrals.

OCCUPATIONAL THERAPY

Patients can be seen by appointment between 8.30am and 4.30pm, Monday – Friday

and by arrangement outside these hours.

Referrals can be made on the normal referral letter.

For further information or to arrange appointments for your patients please contact the

GP Liaison Team.

Urgent outpatient referrals – refer by marking the referral letter or by direct contact

with a consultant or the senior registrar.

Out of hours contact – please telephone the DRI switchboard on 01332 347141.

OMF



urgency.

For urgent appointments within clinic hours (9.00am – 5.00pm) call 01332 254720.

For urgent referrals out of hours please call the hospital switchboard on 01332 347141

and contact the Oral Surgery Senior House Officer on call.

OPTHALMOLOGY

Referrals should be made using the standard referral letter (see preferred example

referral letter) and sent to the Health Records department marked with the degree of

urgency. For adult referrals please send to the DRI, for children’s referrals send to the

Health Records department at the Children’s Hospital.

Acute Emergency Cases with a history of less than 48 hours should be sent to Eye Casualty (situated within the Eye Clinic) with a referral letter. The Eye Casualty is open Monday to Friday between 9am and 4.30pm.

Urgent Appointments with the consultant can be arranged following discussion with

the Sister or Nurse in charge.

If you wish to discuss a case with the doctor, please contact eye casualty on (01332)

254777 or the doctor on-call out of hours.

PAIN MANAGEMENT

GPs may refer their patients by letter. Direct dial clinic telephone number is 01332 254747 (24 hour answering machine).

PALLIATIVE MEDICINE

Outpatients

Referrals may be made to Dr Keeley, Dr Hocknell or Dr Swanwick in writing, by fax

or by telephone.

PATHOLOGY

For microbiology, patient appointments can be arranged between 9.00am and 4.30pm,

Monday to Friday. Please telephone 01332 254687.

Medical advice on haematology problems is available from one of the consultant

haematologists.

PHYSIOTHERAPY

Referrals are taken for any musculo-skeletal condition, however, patients suffering

from the following types of problems would particularly benefit from the service:

Acute spinal conditions Work related conditions Stress incontinence

Recent soft tissue injuries Sports injuries

Patients can be seen by appointment between 8.00am and 5.00pm, Monday – Friday

in the adult service at either the DRI or DCGH and from 8.00am and 4.30pm at the

Children’s Hospital. Referrals with the appropriate patient information should be sent

to:

GP Liaison Team

Therapy Services

Physiotherapy Department

DRI


DCGH


Children’s Hospital

PLASTIC SURGERY

Referrals should be made using the standard letter and sent to the Derbyshire Royal

Infirmary marked ‘urgent’ or ‘routine’.

Urgent requests and queries should initially be directed to the secretary at the DRI.

Patients requiring inpatient plastic surgery will be admitted to Nottingham City

Hosptial. Urgent requests can also be made to the plastic surgeon secretary on 0115

9691169 ext 46706

REHABILITATION MEDICINE


letter) and sent to the Health Records Department of the appropriate site marked with

a degree of urgency.

Urgent outpatient referrals – refer by marking the referral letter or by direct contact

with a consultant or the senior registrar.

Out of hours contact – please telephone the DRI switchboard on 01332 347141.

RENAL MEDICINE

Urgent referrals may be made by telephoning the consultant secretary or contacting

the renal registrar or consultant. Referral letters can be sent directly to the Renal Unit

at the DCGH.

RESPIRATORY MEDICINE


letter) and sent to the Chest Clinic marked urgent or routine. Very urgent requests

should be made directly to the sister or TB health visitor.

Cancer 2 week referrals to be faxed as per proforma.

RHEUMATOLOGY



urgency.

Urgent outpatient referrals should be made by marking the referral letter or by

direct contact with a consultant or the registrar.

Inpatient admissions are normally non-emergency and may be discussed with a

consultant or the registrar.

Out-of-hours consultant contact – please contact the DRI switchboard on 01332

347141 to speak to the on-call consultant.

T & O


letter) and sent to the Health Records department at the DRI marked with the degree

of urgency.

If the patient’s condition gives cause for concern or deteriorates, the first point of

contact is the consultant’s secretary.

UROLOGY

Referrals should be made using the standard referral letter (see preferred example referral letter) and sent to the Health Records department at the DCGH site marked with the degree of urgency.

For emergency or urgent outpatient clinic referrals, the Consultant should be

contacted through their secretaries on the above numbers.

referral guidance - guildford and waverley ccg · referrals should be made on the standard form...

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