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REMEDY : BNSSG referral pathways & Joint Formulary

Referrals (Adult) during COVID-19

Checked: 12-11-2020 by Rob.Adams Next Review: 12-02-2021

Overview

******UPDATE 5.6.20*******

As a result of COVID-19 please see the following key messages regarding referrals: 

  • Routine and Urgent Referrals: Both routine and urgent eReferrals are now available. However, the choices offered to patients may be limited at this time and there may be long waits for appointments. These referrals may be triaged by the referral service or local trusts and may be returned if alternative pathways or access to care is available. We would encourage referrers to continue to use Remedy guidelines or Advice and Guidance services if possible. Where appointments are needed these will usually be delivered remotely (telephone or video consultation). If a face to face assessment is required then appropriate infection control measures will be put in place to protect patients and NHS staff.
  • Key updates: REMEDY will be the central place for the most up to date information
  • Suspected Cancer: 2ww referrals should be made as usual but please be aware that initial contact with patients may be made remotely and normal access to diagnostic tests may be delayed during this time.
  • Same day urgent: Hot clinics referrals are available however access routes and location may change. Updates will be on Remedy
  • Advice & Guidance:  A&G is  now available for most specialties, but should be used judiciously in line with guidance (Please see Advice and Guidance services)
  • Referral support service and REMEDY: Will be the place for up to date referral information and advice (see REMEDY or email: bnssg.referral.service@nhs.net)
  • GPs are advised to supply their mobile phone number for calls, texts or whatsapp comms from the consultant. We would like to encourage clinical discussion around more complex cases as this will increase the value of the advice consultants can give.
  • Radiology: Access to routine radiology remains restricted. Open access/acute and urgent investigations can still be requested but adequate clinical information must be supplied otherwise requests may declined. Please check radiology guidelines during COVID-19.

 

Please use Remedy guidelines or Advice and Guidance services where available.

We will endeavour to keep Remedy up to date with changes to services as and when they occur (and when we are informed). Please feedback (Feedback button on top right of screen) to us if you are having problems getting up to date information regards particular services. We will try and provide any help or support that we can. 

Advice for Specific Services

  • Endoscopy - access to  non-2WW endoscopy services is still limited. Please see the Endoscopy during COVID-19 page for up to date details. If referral is required please submit via eRS using the relevant BNSSG endoscopy referral form. Waits for non-urgent endoscopy are likely to be very long so please manage patient expectation during this time. 
  • Neurology (NBT): The neurologists at NBT now have an Advice and Guidance service available to access via eRS for all BNSSG practices. There is also a telephone line for more urgent advice and support for clinicians.
  • Cardiology (BHI): All walk in ecg services have been suspened. ECG's done in practice can be forwarded via A and G for reporting if needed. The Rapid Access Chest Pain Clinics will continue as normal.
  • Community Paediatrics: See the CCHP Clinician home page for details of services.
  • Vasectomy: The vasectomy service is accepting referrals
  • Dental Hospital Closed to walk in referrals.
  • Radiology - please see Radiology during COVID-19 page for further information.
  • Bristol Eye Hospital - please see Ophthalmology and COVID-19
  • Unity Sexual Health Services - Information for Primary Care Updated 28-05-20.
  • Bristol ROADS Shared Care - urine screens are required to commence Shared Care Opioid Substitution Treatment. See Shared Care page for updated information.
  • Community Referrals (Sirona). Please see the Sirona: Information for Clinicians page for latest updates on services.

 

Advice and Guidance and RAS

In order to support GPs trusts have now provided Advice and Guidance services or Referral Assessment Services (RAS) for most specialties via eRS. 

If you cannot find the service you require please inform the Referral Support Service.

Urgent and 2WW Referrals

Urgent referrals should still be sent via eRS but consider guidelines and A and G services prior to referral if appropriate. Please be aware that these referrals may be triaged by the Referral Service and/or trusts to check they are appropriate before they are accepted.

HOT clinic referrals can continue to be sent via usual routes 

2WW referrals should proceed along normal pathways in line with existing criteria.

BNSSG  2WW Patient Information Leaflet. - COVID-19 Edition

Link to leaflet on CCG website: https://bnssgccg.nhs.uk/library/understanding-two-week-wait-urgent-referrals-and-covid-19/ 

The leaflet via this link is available in English and 14 additional languages.

 

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Patient information

Please see the CCG page for latest updates for patients:

Health Services during Coronavirus