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Referral Guidance
A & E
GPs are strongly requested to contact the specialty teams DIRECTLY WHEN
APPROPRIATE to avoid unnecessary delays for their patients in A & E. Relevant
non-urgent conditions can be given an early A & E clinic appointment to see a
consultant. If the surgery contacts the department, an appointment time will be given
over the telephone on 01332 347141 ext 2170. The patient may then present with a
letter at the appropriate time and will be booked in for their appointment.
AUDIOLOGY
DIRECT REFERRAL SERVICE FOR THE ELDERLY DEAF
The Direct Referral Service is specifically designed for those patients with simple
age-related sensorineural deafness, who meet the referral criteria (see below). Initial
assessments are undertaken by Senior Audiologists and include a case history,
otological examination and an audiological evaluation.
Patients meeting a second set of criteria then have an aural impression taken and are
subsequently fitted with a hearing aid. Those not meeting this criteria are referred on
to the ENT department for a medical opinion.
Referrals
Referrals should be made on the standard form contained within the Direct Referral
Information Booklet (available from this department) together with a referral letter
routinely used by the GP practice. Referrals should be sent directly to the Audiology
Department. Please provide the necessary information for patients requiring
transport.
Referral Criteria
There is an agreed GP protocol for the direct referral of the elderly deaf requiring
hearing aids:
1. Patients should be 60 years of age or over
2. Patients should be examined by their GP:
- wax should be removed from both ears as and when necessary
- examination should reveal normal eardrums
3. Patients should show no evidence of:
- sudden onset of deafness
- history/signs of active discharge from either ear
- otalgia affecting either ear
- vertigo
- previous ear surgery
- fluctuating hearing loss (not associated with the common cold)
- continued tinnitus
- any other unusual presenting feature, ENT or hearing abnormality
Audiology Referrals
Patients with hearing problems should be referred either to ENT or the Audiology
Department in the usual manner. If a hearing aid is prescribed, patients can choose to
purchase a private aid, in addition to, or in place of the NHS aid.
Patients wishing to specifically use the private service many contact the department
directly, without any referral from the GP. However, if certain medical conditions
were found to be present, patients would be referred back to their GP.
NB: This service is available at the Audiology Department or in the patient’s own
home for those people not physically able to get to the hospital.
CARDIOLOGY
Outpatient Referrals
Referrals should be made using the standard letter (see preferred example referral
letter) and sent to the Health Records department of the appropriate site marked with
the degree of urgency.
CLINICAL HAEMATOLOGY
Referrals
Patients can be referred by letter, fax or telephone to the consultant’s secretary.
Emergency admissions to the ward can be arranged by discussion with the consultant
or registrar.
Existing patients are able to refer themselves to the clinic or day ward if necessary.
The senior medical team provide 24-hour cover for haematology patients and for
advice to colleagues. They can be contacted out of hours via the DRI switchboard on
(01332) 347141.
Anticoagulant Referrals
Contact Sister Salinder Gill or Sister Kate Welch on (01332) 347141 ext 2796 or
(01332) 254770 Monday to Friday between 8.45am and 5.00pm. Alternatively they
can be contacted via bleeps 3427 / 3426.
CLINICAL ONCOLOGY
Referrals
Patients can be referred by letter or telephone to the consultants secretary.
Emergency admission to the ward can be arranged by discussion with the consultant
or Ward 17 SHO’s.
Existing chemotherapy patients are able to refer themselves to the clinic or ward if
necessary.
DERBYSHIRE CHILDRENS HOSPITAL
Referrals
Routine Referral for Consultants
To be addressed to the New Referrals Department, Derbyshire Children’s Hospital,
Uttoxeter Road, Derby.
Urgent Referrals
For outpatient appointments telephone 01332 625654 or 340131 ext 6805. Urgent
referrals can be faxed to 01332 625629.
Emergency Referrals
Ring 01332 340131 and ask for first, on-call for paediatric medical referrals or
second, on-call for paediatric surgical referrals.
Direct Access Referrals
Physiotherapy
Specialist Paediatric Physiotherapy services are not available elsewhere in Derby on
Direct Access. Services are available Monday to Friday, 8.00am – 12.00pm and
1.00pm – 4.00pm. Direct dial telephone number 01332 625539.
Psychology
Services are available Monday – Friday, 9.00am – 5.00pm. This applies to both the
Children’s Hospital and the Ronnie MacKeith Centre. Referrals are to be addressed
to Sue Rhead, Director of Clinical Psychology.
X-Ray
Services available:
Monday and Wednesday 9.30am – 12.00pm and
2.00pm – 4.00pm
Thursday 9.30am – 12.00pm
Friday 2.00pm – 4.00pm
Direct dial telephone number 01332 625540.
Orthoptic Services
Secondary orthoptic screening service is provided for 0 – 8 year olds. Primary
orthoptic screening service for children aged 3 – 4 years old is provided in the
community in partnership with Child Health Services
Audiology
Community Audiology Services can be contacted on 01332 625663.
DERMATOLOGY
Referrals
Outpatient
Referrals should be made using the standard letter (see preferred example referral
letter) and sent to the Health Records department marked with the degree of urgency.
For adult referrals please send to the DRI, for children’s referrals send to the Health
Records department at the Children’s Hospital.
Suspected Skin Cancers
Suspected skin cancer referrals (Melanoma and SCC) should be made using the
standard letter contained in the ‘Referral Guidelines for Suspected Cancer’ and faxed
to the department
DIABETES
Outpatient Referrals
Referrals should be made using the standard letter (see preferred example referral
letter) and sent to either the Health Records department at the DRI (medical
outpatients referrals) or the Jenny O’Neill Centre (Diabetes referrals) marked with the
degree of urgency.
The following specialist clinics can be accessed via routine clinics held in the
Diabetes Unit: erectile dysfunction, painful neuropathy (acupuncture), nephropathy,
ante-natal, nurse-led pump clinic, tablets to insulin groups, clinical psychology, sensor
clinic, low calorie diet clinic, elderly clinic.
Urgent Referrals (eg newly diagnoses young patients likely to need insulin) should be made by telephone to the Diabetes Unit or one of the consultants’ secretaries.
ENT
Referrals
Referrals should be made using the standard letter (see preferred example referral
letter) and sent to the Health Records Department at the DRI marked with a degree of
urgency.
If you wish to discuss an urgent case you can contact the doctor on-call. For any
information relating to a patient’s appointment contact the nursing staff or the medical
secretaries.
GASTROENTEROLOGY
Outpatient Referrals
Referrals should be made using the standard letter (see preferred example referral
letter) and sent to the Health Records Department of the appropriate site marked with
a degree of urgency.
Very urgent requests should be telephoned to the consultant secretary or by the 2-
week cancer route if appropriate.
GENERAL SURGERY
Referrals
Routine Referrals
Outpatient referrals should be made using the standard letter (see preferred example
referral letter) and sent to the Health Records department of the appropriate site
marked with the degree of urgency. Please refer to ‘Clinic Schedules’ below for
correct site.
Urgent Referrals
For emergency or urgent outpatient clinic referrals, the consultants should be
contacted through their secretaries on the numbers shown above.
Breast Surgery Referrals
Regular Radiological and Surgical outpatient clinics are held at the Breast Unit for
symptomatic breast referrals. Referrals should be made by letter directly to the Breast
Unit and not to General Surgery. All referrals for patients which are deemed
clinically urgent should be faxed directly to the Breast Unit (Fax: 01332 298719).
GUM
Referrals
Patients may self-refer by using the ‘Walk In’ service between 9.00am – 10.00am
Monday to Friday, or 2.00pm – 3.00pm Monday and Thursday.
Referrals should be made using the standard form and sent direct to the clinic at the
Derbyshire Royal Infirmary.
Cross referrals are made to and from Gynaecology, Haematology and other
specialties.
IMAGING
Referrals
Plain Film Radiography
Appointment not necessary, patients should present to :
X-Ray 1 DRI 9.00am – 12.00pm
2.00pm – 4.30pm
Monday – Friday only
Main X-Ray DCGH 9.00am – 12.00pm
2.00pm – 4.30pm
Monday – Friday only
Children’s X-Ray 9.00am – 12.00pm
2.00pm – 4.30pm
Monday, Wednesday, Thursday and Friday only
All patients must have an appropriately completed and signed request form, giving sufficient relevant clinical information as to justify the examination.
Ultrasound Examinations
General Ultrasound Examinations
Appointments are required for Ultrasound examinations. Request forms should be
sent direct to the Ultrasound Department at either the DRI or DCGH site. Patients
will be notified with a suitable appointment time. Requests for clinically urgent
examinations should be telephoned to either Ultrasound Department:
DRI 01332 254721 DCGH 01332 625518
All patients must have an appropriately completed and signed request form, giving
sufficient clinical information to justify the examination.
Obstetric Ultrasound
1st Trimester: confirmation, viability & dating scans, up to 18 weeks
Appointments are required for these examinations. Appointments can be booked
directly by telephone by referring clinician or midwife (01332 625736), or by sending
a request form. All patients must have an appropriately completed and signed request
form, giving sufficient clinical information to justify the examination.
2nd
& 3rd
Trimester – 18 week to term
Appointments are required for these examinations. Appointments can be booked
directly by telephone by referring clinician or midwife (01332 625674), or by sending
a request form. All patients must have an appropriately completed and signed request
form, giving sufficient clinical information to justify the examination.
GI and other Contrast Examinations
Appointments are required for these examinations. Request forms should be sent
direct to X-Ray 2 at the DRI or main X-ray at DCGH. Patients will be notified of a
suitable appointment time. Requests for clinically urgent examinations should be
telephoned to:
DRI 01332 254838 DCGH 01332 625519
Bone Densitometry
Appointments are required for these examinations. Request forms should be sent
direct to Bone Densitometry, Main X-Ray at DCGH. Patients will be notified of a
suitable appointment time.
CT Examinations
Appointments are required for these examinations. Request forms should be sent
direct to CT Department at the DRI, or Main X-Ray at DCGH. Patients will be
notified of a suitable appointment time.
BREAST CANCER REFERRALS
Urgent suspected Breast Cancer referrals should be faxed on the correct Derby Cancer
Centre referral form, direct to the Breast Unit on 01332 298719. These cases are seen
within 14 days.
Guidelines for urgent referrals include:
New lump – especially age greater than 30 years Dimpling or distortion or changes in the shape of the breast Nipple retraction
Routine non-urgent requests – GPs should refer by letter, direct to the Breast Unit.
These referrals are usually seen within 4 weeks.
Family History referrals – these should be made on the FHGP referral form and can
then be acted upon appropriately.
KINGS LODGE
Referrals
Medical Consultants, General Practitioners and Health Professionals can make
referrals for elective admissions and/or assessment of needs either by phone or in
writing.
MEDICINE FOR THE ELDERLY
Outpatient and Domiciliary Referrals
Letters must state if ambulance transport is required and indicate if an escort will be
in attendance.
Derbyshire Royal Infirmary Referrals
Referrals should be made using the standard letter (see preferred example referral
letter) and sent to the Department of Medicine for the Elderly, Bed Bureau, DRI.
Letters may be named or un-named and should indicate urgent or non-urgent. Urgent
referrals to the DRI consultants can also be telephoned / faxed via Bed Bureau.
Derby City General Hospital
Referrals should be made using the standard letter (see preferred example referral
letter) and sent to the Health Records department, DCGH.
For urgent referrals to DCGH, please telephone the consultant’s secretary.
Community Hospital Clinics
Referrals should be made using the standard letter (see preferred example referral
letter) and sent to the individual hospitals concerned.
Day Hospital Referrals
Please use the same system as for outpatient referrals.
NEUROLOGY / NEUROSURGERY
Referrals should be made using the standard letter (see preferred example referral
letter) and sent to the Health Records Department at the DRI marked with a degree of
urgency. Very urgent requests should be telephoned to the consultant secretary.
NUTRITION AND DIETETIC SERVICES
Referrals should be made using either the dietetic referral form or by letter. All
referrals must be completed with patient details including medical condition and
signed by a registered medical practitioner.
Across the two sites, there are general dietetic outpatient clinics held at specific times
on
NUTRITION TEAM SERVICES
Referrals should be made in writing, including patient details, medical condition and
reason for referral and sent to the Dietetic or Nutrition department. A registered
medical practitioner should sign all referrals.
OCCUPATIONAL THERAPY
Patients can be seen by appointment between 8.30am and 4.30pm, Monday – Friday
and by arrangement outside these hours.
Referrals can be made on the normal referral letter.
For further information or to arrange appointments for your patients please contact the
GP Liaison Team.
Urgent outpatient referrals – refer by marking the referral letter or by direct contact
with a consultant or the senior registrar.
Out of hours contact – please telephone the DRI switchboard on 01332 347141.
OMF
Referrals should be made using the standard letter (see preferred example referral
letter) and sent to the Health Records Department at the DRI marked with a degree of
urgency.
For urgent appointments within clinic hours (9.00am – 5.00pm) call 01332 254720.
For urgent referrals out of hours please call the hospital switchboard on 01332 347141
and contact the Oral Surgery Senior House Officer on call.
OPTHALMOLOGY
Referrals should be made using the standard referral letter (see preferred example
referral letter) and sent to the Health Records department marked with the degree of
urgency. For adult referrals please send to the DRI, for children’s referrals send to the
Health Records department at the Children’s Hospital.
Acute Emergency Cases with a history of less than 48 hours should be sent to Eye Casualty (situated within the Eye Clinic) with a referral letter. The Eye Casualty is open Monday to Friday between 9am and 4.30pm.
Urgent Appointments with the consultant can be arranged following discussion with
the Sister or Nurse in charge.
If you wish to discuss a case with the doctor, please contact eye casualty on (01332)
254777 or the doctor on-call out of hours.
PAIN MANAGEMENT
GPs may refer their patients by letter. Direct dial clinic telephone number is 01332 254747 (24 hour answering machine).
PALLIATIVE MEDICINE
Outpatients
Referrals may be made to Dr Keeley, Dr Hocknell or Dr Swanwick in writing, by fax
or by telephone.
PATHOLOGY
For microbiology, patient appointments can be arranged between 9.00am and 4.30pm,
Monday to Friday. Please telephone 01332 254687.
Medical advice on haematology problems is available from one of the consultant
haematologists.
PHYSIOTHERAPY
Referrals are taken for any musculo-skeletal condition, however, patients suffering
from the following types of problems would particularly benefit from the service:
Acute spinal conditions Work related conditions Stress incontinence
Recent soft tissue injuries Sports injuries
Patients can be seen by appointment between 8.00am and 5.00pm, Monday – Friday
in the adult service at either the DRI or DCGH and from 8.00am and 4.30pm at the
Children’s Hospital. Referrals with the appropriate patient information should be sent
to:
GP Liaison Team
Therapy Services
Physiotherapy Department
DRI
Physiotherapy Department
DCGH
Physiotherapy Department
Children’s Hospital
PLASTIC SURGERY
Referrals should be made using the standard letter and sent to the Derbyshire Royal
Infirmary marked ‘urgent’ or ‘routine’.
Urgent requests and queries should initially be directed to the secretary at the DRI.
Patients requiring inpatient plastic surgery will be admitted to Nottingham City
Hosptial. Urgent requests can also be made to the plastic surgeon secretary on 0115
9691169 ext 46706
REHABILITATION MEDICINE
Referrals should be made using the standard letter (see preferred example referral
letter) and sent to the Health Records Department of the appropriate site marked with
a degree of urgency.
Urgent outpatient referrals – refer by marking the referral letter or by direct contact
with a consultant or the senior registrar.
Out of hours contact – please telephone the DRI switchboard on 01332 347141.
RENAL MEDICINE
Urgent referrals may be made by telephoning the consultant secretary or contacting
the renal registrar or consultant. Referral letters can be sent directly to the Renal Unit
at the DCGH.
RESPIRATORY MEDICINE
Referrals should be made using the standard letter (see preferred example referral
letter) and sent to the Chest Clinic marked urgent or routine. Very urgent requests
should be made directly to the sister or TB health visitor.
Cancer 2 week referrals to be faxed as per proforma.
RHEUMATOLOGY
Referrals should be made using the standard letter (see preferred example referral
letter) and sent to the Health Records Department at the DRI marked with a degree of
urgency.
Urgent outpatient referrals should be made by marking the referral letter or by
direct contact with a consultant or the registrar.
Inpatient admissions are normally non-emergency and may be discussed with a
consultant or the registrar.
Out-of-hours consultant contact – please contact the DRI switchboard on 01332
347141 to speak to the on-call consultant.
T & O
Referrals should be made using the standard letter (see preferred example referral
letter) and sent to the Health Records department at the DRI marked with the degree
of urgency.
If the patient’s condition gives cause for concern or deteriorates, the first point of
contact is the consultant’s secretary.
UROLOGY
Referrals should be made using the standard referral letter (see preferred example referral letter) and sent to the Health Records department at the DCGH site marked with the degree of urgency.