Summary of referral proforma/thresholds/NICE guidance and other guidelines for ENT/Gastro/Gynae/Urol /Derm RSS 2013/2014 A’brookes proforma (N3) CCG policy CCG proforma NICE Clinical Guidance Addenbrookes ENT Referral Guidelines ENT GPSI Allergic Rhinitis Audiology Chronic Rhinitis Discharging ear globus grommets Menieres Nasal polyps Snoring/OSA tinnitus tonsillectomy vertigo Other guidelines yes GPSI service inclusions/exclusions CKS Checklist on policy yes Western Sussex Hospital Guidelines Western Sussex Hospital Guidelines Globus sensation patient.co.uk yes yes CKS Western Sussex Hospital guidelines Plymouth referral guidelines-no date Western Sussex Hospital Guidelines yes yes Western Sussex Hospital guidelines Gastroenterology Dyspepsia Irritable Bowel Syndrome Diarrhoea yes yes yes yes CG17 CG61 CATCH/Addenbrooke’s guidelines CKS Acute and Chronic Diarrhoea Gynaecology CATCH Women’s Health Pages Anovulatory bleeding Cervical Polyps Chronic Pelvic pain Colposcopy Heavy menstrual bleeding IMB/PCB CATCH CATCH also Kernow CCG Guidelines Addenbrookes protocol (N3), ELIC Infertility IUD problems Ovarian cysts PCOS Premenstrual syndrome Prolapse no yes yes no CG44 yes CATCH IMB CATCH PCB Post coital Bleeding – Addenbrooke’s Pathways CG156 yes CATCH ovarian cysts and Top Tips CATCH PCOS CKS guidelines RCOG Pelvic organ prolapse patient info Ring pessary self management sterilisation Sterilisation reversal Urinary incont/prolapse Vulval disorders no yes yes yes CCS pathway (some links need updating) York RSS guidelines Urology Camurology guidelines balanitis circumcision Epididymal cysts epididymitis Camurology balanitis yes Dr Christine Emerson CATCH updated 09/05/14 yes Camurology epididymal cysts Camurology epididymitis Summary of referral proforma/thresholds/NICE guidance and other guidelines for ENT/Gastro/Gynae/Urol /Derm RSS 2013/2014 A’brookes proforma (N3) hydrocele Incontinence LUTS (male) Phimosis/paraphimosis prostatitis PSA measurements Renal stone UTI Varicocele Scrotal swellings yes CPHN policy CPHN proforma NICE CG CG97 no Leg ulcers Molluscum contagiosum psoriasis Solar keratoses Solitary non-pigmented lesion urticaria Viral warts Camurology hydrocele Camurology incontinence Camurology Camurology phimosis Camurology prostatitis Camurology PSA Camurology renal calculi Camurology chronic cystitis Camurology varicocele CKS scrotal swellings CATCH dermatology pages Dermatology Acne Alopecia areata Basal cell carcinoma Benign skin lesions Eczema (hand) Eczema (not hand) Fungal infection skin/nails hyperhidrosis Other guidelines yes Addenbrooke’s Acne Addenbrooke’s Alopecia areata Adddenbrooke’s BCC yes yes Yes yes Addenbrooke’s Eczema Yes (for botulin um) yes Addenbrookes fungal skin/nails Addenbrooke’s hyperhidrosis Yes (for botulinu m) CG153 Addenbrooke’s leg ulcers Addenbrooke’s mollscum Addenbrooke’s psoriasis Addenbrooke’s solar keratoses yes Addenbrooke’s urticaria Addenbrooke’s viral warts Common reasons for patients not being fit for surgery found at Pre-operative Assessment Clinic (POAC) 1. Hypertension - BP >160/90 after 3 consecutive readings 2. Diabetes – HbA1c > 64 mmol/mol – elective surgery; >75 mmol/mol - urgent (cancer, symptomatic carotid artery stenosis) 3. Recent worsening of angina 4. New onset AF diagnosed at POAC 5. AF heart rate > 100 bpm 6. Chest infection (on day of surgery or within 2 weeks of surgery) 7. New heart murmur diagnosed on auscultation of the chest The following information would be of great help both to the Trust and to the patients if it were to be present in all referral letters Dr Christine Emerson CATCH updated 09/05/14 Summary of referral proforma/thresholds/NICE guidance and other guidelines for ENT/Gastro/Gynae/Urol /Derm RSS 2013/2014 Current BP reading Any diagnosis of hypertension If under investigation for any other condition Height Weight BMI Smoking status If diagnosed diabetic the current HbA1c (with date of measurement) Cardiac history and most recent echo/angiogram date and result Known previous MRSA and C diff status Dr Christine Emerson CATCH updated 09/05/14