Hampshire Hospitals referral guidance, forms & useful information

Referral criteria - (Basingstoke and North Hampshire Hospital)

Referral criteria - (Royal Hampshire County Hospital, Winchester)

Public Health in Hampshire - support for adults who want to lose weight 

Wessex Academic Health Science Network - Nutrition in older people

Dear Primary Care Colleagues,

Endoscopy is an aerosol generating procedure, and a significant number of patients attending the unit are over 70. This means that both staff and patients are at risk of Covid 19 infection during the procedure itself, and whilst waiting and recovering in the endoscopy unit/DTC.

With current pressure rising on the secondary care service, and in line with guidance from the BSG/JAG, we are stopping all non-emergency endoscopy after Friday- with only a few urgent and TWR patients under 70 on the lists for the next 3 days. Bowel Cancer Screening and Bowel Scope flexible sigmoidoscopy has paused with immediate effect. These measures will reduce the risk of infection to both patients and staff, and will release staff for front line activity and redeployment.

In order to try and manage on-going demand, we have decided to suspend GP direct access requesting via ICE, so that all requests for out-patient endoscopy must come through the ERS as a single point of triage by consultants.

We have cancelled all procedures which had already been scheduled for the next 6 weeks, and informed patients by telephone if short notice cancellation.

All patients who have been cancelled, are on the waiting list to be booked, and who are currently joining the waiting list will be sent a letter explaining the circumstances. They are being asked to call a helpline number if they feel that their symptoms are too severe to wait – and they are asked to keep the number to hand in case their symptoms deteriorate to an unmanageable level before they are listed for a procedure. It is clear that it may be several months before we can resume normal service. The helpline will be manned by a clerical team who will either direct the patient back to their primary or secondary care team for advice, or escalate the query to a member of the endoscopy clinical team. This clinical team will be supported by a consultant. There will inevitably be a few patients who need their procedure doing –and there will be capacity for a small number of procedures in those it is safe to bring up to the unit. We aim to identify and manage those via patient initiated contact to this helpline number but are hoping that the helpline will not be overwhelmed with anxious patients.

We will still be offering emergency endoscopy for in-patients, and those out-patients requiring intervention for acute presentation of IBD, oesophageal and colonic stents, oesophageal dilatation, feeding tubes and ERCP – especially if it will help to keep them out of hospital.

We are grateful for your help during this time to manage expectation and try and limit referrals where possible. We would like to suggest that when referring a patient to join the waiting list – you do consider starting treatment, as there will be long delays. We would support you in starting iron in those who are deficient, PPI/Acid suppression in those with dyspepsia/dysphagia/suspicion of peptic ulceration, and a gluten free diet in patients with positive coeliac serology. Dietitians can take direct referral and do telephone appointments to support potential new coeliac disease patients, and we can always do a gluten challenge later to confirm the diagnosis.

Please feel free  to contact us via Advice and Guidance if you need clinical support at this difficult time, and thank you again for your support.

With best wishes

Dr Corinne Brooks
Consultant Gastroentoerologist
Clinical Lead for Gastroenterology
Hampshire Hospitals NHS Foundation Trust

Tel: 01256 314859

Guidelines for the management of patients on warafrin or direct oral anticoagulants (DOAC) undergoing endoscopic procedures

Guidelines for the management of patients on P2Y12 receptor antagonist antiplatelet agents undergoing endoscopic procedures

Anticoagulant counselling template

Anticoagulant decision aid flow chart

Anticoagulation decision aid flow chart – supporting information

Bleeding and Thrombosis GP FAQs

Guidance for the safe switching of warfarin to direct oral anticoagulants (DOACs) for patients with non-valvular AF and venous thromboembolism (DVT / PE) during the coronavirus pandemic

Menopause and clots

Orthodontics referral form - over 18

Orthodontics referral form - standard

Dental Electronic Referral System (DeRS):

Please note that Hampshire Hospitals NHS Foundation Trust will commence using the DeRS system to receive all Orthodontic referrals from 7th February 2020. All Dental referrals must be sent through this system in order to be processed.

Please note that the Central Referral Centre (CRC) will only be in place for a short time after the transition to DeRS. Practices are encouraged to provide as much information as possible on their DeRS referral to enable the teams to triage patients appropriately to see the right clinician in a time appropriate to their clinical urgency.