Shaping better health
REMEDY : BNSSG referral pathways & Joint Formulary

Advice and Guidance during COVID-19

Checked: 13-08-2020 by vicky.ryan Next Review: 02-10-2020


Advice & Guidance services already in place through e-RS will continue to be managed through the usual process:

Please see the attached Good Practice for Advice & Guidance v1.0

Secondary care teams are asking colleagues to be judicious in the use of advice and guidance during the crisis. The referral team suggest using the following 5 scenarios as appropriate criteria when seeking support in managing patients:

  1. Diagnostic uncertainty that will affect safe / effective management of patient
  2. Uncertainty around clinical management (once REMEDY pathway guidelines have been checked) that will affect safe / effective management of patient
  3. Support to interpret primary care diagnostics (e.g. ECG) that will affect management
  4. Patients on a follow up pending list who have been deferred and present in primary care with problem that GP cannot manage alone
  5. Clarification of prioritisation between routine and urgent.

It is also suggested that referrers include their mobile telephone numbers when requesting A and G so that clinicians can contact them directly if needed to discuss a patient's care.

To enable the consultants to give the best advice possible please also consider the following points:

  • Give a clear concise history and examination findings- avoid cutting and pasting long lists of consultation notes that are not relevant to the problem in hand.
  • Include relevant results, investigations and recent correspondence if appropriate but avoid multiple attachments that can take time to download and make the triage process more cumbersome.
  • Ask a clear clinical question and avoid ambiguity.
  • Avoid requests for complex patients known to an individual consultant as they are unlikely to be the consultant giving the advice and may not have easy access to details of previous contacts with the patient. In these cases consider writing or emailing the relevant secretary directly.


If primary care would like advice from a specialist team and this is not currently available through an existing Advice and Guidance service on eRS then please see the attached contact details (30.07.20) . Please remember to include [SECURE] in the subject title if the email address is not

NBT Advice & Guidance services already in place through e-RS will continue to be managed through the usual process (please see Remedy Advice & Guidance pages linked above)

Responses will be returned within 7 calendar days. If a response has not been received within 7 calendar days please escalate this via

Ask the Med Reg

Ask the Medical Reg service ends 30th June 2020 as they return to clinical practice from 1st July.

This is being replaced by Care of the Elderly, Geriatrician of the day. Phone: 07738 859048 (Monday – Friday 8am – 4pm)


Please use eRS to access Advice and Guidance services for UHB and Weston (UHBW).

Please see the full list of services now available (15.05.20) on eRS. 

Do you have a question about a medical admission or hot clinic at the BRI? Call the AMU consultant advice line

  • The AMU consultant advice line is now available on 0117 3426860, open 9am-5pm Monday to Friday. Calls welcome from primary care and hospital staff.
  • GPs can ring and talk to a Consultant in Acute Medicine if there is a patient they would like to refer for admission. The consultants are also able to offer alternatives such as an appointment the following day if this prevents people having to come in later in the evenings for example, where they are more likely to be admitted for an overnight stay.
  • The line goes straight through to consultants with no call handler.


Please see the Referrals (Paediatric) during COVID-19 page for details on paediatric servcies including A and G.


There should be some form of advice & guidance available for all specialties. If you cannot find the service you require please inform the Referral Support Service.

Community Services Advice & Guidance

Sirona Care & Health have set up advice & guidance services for GPs in the following areas:

Respiratory Advice & Guidance Service

Community Dermatology A&G for diagnosed patients.

MSK Advice & Guidance


Clinician Advice Line

Clinician Email Advice


07799 478679

North Somerset

07980 934977

South Gloucestershire

0117 340 8452


Diabetes Advice & Guidance

From 1 August 2020, Sirona care & health’s Community Diabetes Service is launching an advice and guidance service across BNSSG.

The service, which is for healthcare professionals only, is available between 8am-5pm, Monday-Friday and run by a team of Community Diabetes Specialists.

Tel: 0117 9598970   Email:


 Learning Disabilities advice and guidance line - Bristol only