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REMEDY : BNSSG referral pathways & Joint Formulary

Upper GI - 2WW

Checked: 16-09-2019 by vicky.ryan Next Review: 06-01-2020

Service Overview

Services provided by UHBristol at Bristol Royal Infirmary and NBT at Southmead Hospital and WAHT at Weston General Hospital. The services are for patients who meet the Upper Gastrointestinal Cancer Two Week Wait criteria. The service offers consultation with diagnostics and onward referral for treatment as required.

Please see link for further NICE Cancer Guidelines 2015 - Upper GI Tract Cancers

At time of referral please issue the relevant patient information leaflet as detailed in section below.

Patients with suspected pancreatic cancer should also be referred using the referral form below but also see the Pancreas - 2WW section for further details and link to local pathway.

Referral Guidance

Patients should meet the referral criteria as indicated on the BNSSG Upper Gastrointestinal Cancer Referral Form (word doc).  which should be embedded on your EMIS system.

At time of referral please issue the relevant patient information leaflet as below:

NBT's 2WW Patient Information Leaflet 

UHB's 2WW Patient Information Leaflet.

WAHT 2WW Patient Information Leaflet


2WW Upper GI referrals can also be sent via ICE to NBT. See the NBT 2 week wait upper GI pathway.


****STOP PRESS**** (September 2019)

Please note that iron deficiency anaemia (IDA)  alone is not an indication for 2WW upper GI referral. In these cases it is advised that lower GI investigations should be prioritised. Please see the lower GI 2WW criteria initially as 2WW lower GI endoscopy or FIT test may be indicated depending on age and other symptoms. There is also advice on management of IDA in the Anaemia page of Remedy.
If upper GI endoscopy is required then referrals should be sent to a community endoscopy provider (outside of 2WW).
Please see the Endoscopy page for details.
The current Upper GI 2WW form is currently being reviewed in light of the above. Trusts may also decline 2WW referrals if the criteria are not met. If you still have high suspicion of upper GI cancer then please clearly indicate why on the 2WW form to avoid any delays to referral.