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REMEDY : BNSSG referral pathways & Joint Formulary

Upper GI - 2WW

Checked: 31-01-2020 by vicky.ryan Next Review: 29-01-2021

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.


Iron Deficiency Anaemia

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.

Referral Guidance

BNSSG Upper Gastrointestinal Cancer Referral Form (word doc).  (updated January 2020)

Use the form above to make a referral (embedded in EMIS systems).

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

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

Link to leaflet on CCG website:


NBT 2WW Upper GI referrals

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

Stop Press **** February 2020***. Due to high demand NBT are outsourcing some referrals for upper GI scopes (including 2WW and Barrett's surveillance) to Prime endoscopy. Patients should still be referred in the usual way but should be warned that they may be contacted by Prime rather than NBT for their investigation. This will not delay patient care pathways..