Medicine

This section is provided for health professionals (GPs, dentists, pharmacists etc).

Members of the general public are welcome to use these pages but should be aware that they are not written with them in mind. Please choose an option on the left for information aimed at the general public.

Cardiology

• Cardiac rehabilitation referral form (60kb Word file)
• Community heart failure nurse referral (79kb Word file)
• Community heart failure nurse referral - EMIS (100kb Word file)
• Direct access echo referral form - EMIS (65kb Word file)
• Echo referral form (60kb Word file)
• Rapid access chest pain clinic (35kb Word file)
• Rapid access chest pain clinic - EMIS (40kb Word file)
• Rapid access heart failure -EMIS (50kb Word file)
• Identification and management of familial hysercholesterolaemia (71kb pdf file)
• Simon Broom Diagnostic Criteria for Index individuals and relatives (1MB pdf file)

Care of elderly

• Anticipated need plan (32kb Word file)
• Falls screening referral and past medical history (107kb Word file)
• Food as treatment information (90kb PDF file)
• Malnutrition Universal Screening Tool (327kb PDF file)
• Occupational therapy referral form (82kb Word file)
• Osteoporosis referral form (34kb Word file)
• The rapid-access clinic for older people (RACOP) (41kb Word file)
• TIA referral form (35kb Word file)
• TIA referral form - EMIS (50kb Word file)

Chronic Fatigue Syndrome / ME

• CFS/ME referral form (75kb Word file)
• CFS/ME referral form - EMIS (80kb Word file)
• Skin camouflage referral form - EMIS (40kb Word file)

Dermatology

• Community dermatology LES - EMIS (50kb Word file)
• Community IV Cellulitis Service referral pathway information (83kb Word file)
• Dermatology LES referral form (32kb Word file)
• Leg ulcer clinic referral form (40kb Word file)
• Leg ulcer referral - EMIS (40kb Word file)
• Minor ops LES interpractice referral form (38kb Word file)
• Minor surgery DES - EMIS ( 50kb Word file)
• Skin camouflage information sheet for GPs (56kb Word file)
• Skin camouflage system (26kb Word file)
• Skin camouflage leaflet (575kb PDF file)
• Skin camouflage service referral form (EMIS) (23kb rtf file)
• Skin camouflage service referral form (NON EMIS) (82kb rtf file)

Dentistry

• Special Care Dental Service referral criteria (135 kb Word file)
• Special Care Dental Service referral form -All patients (104kb Word file)
• Special Care Dental Service referral - GA Paediatric (104kb Word file)

Endocrinology

• Annual diabetes foot risk assessment (43kb Word file)
• DESMOND new referral criteria 2011 (1mb Word file)
• DESMOND new referral form 2011(1mb Word file)
• Diabetic retinopathy screening (33kb Word file)
• Insulin/ GLP-1 referral criteria (43kb)
• Insulin/ GLP-1 initiation referral form (52kb Word file)
• Joint management referral criteria 2011 (47kb Word file)
• Joint management referral form 2011 (51kb)
• Pre diabetes referral criteria 2011 (37kb Word file)
• Pre diabetes referral form 2011 (54kb Word file)

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GUM

• BHIVA vax guidelines - GP version (64kb Powepoint file)

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Haematology

• Blood loss protocol (34kb PDF file)
• Hospital only anticoagulant referral form (49kb Word file)
• Anticoagulation consent form (210kb
• BICS referral guideline (715 kb word file)
• CPAMS list of pharmacies (28 kb word file)
• CPAMS Patient Pathway v7 (381 kb word file)
• CPAMS referral form - Non EMIS version (40kb Word file)
• Menstrual calendar (80kb PDF file)
• DVT clinic referral (48kb Word file)
• Warfarin referral guidelines (717kb Word file)
• Wells score - DVT screening tool (32kb Word file)

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Infectious diseases

• Advice following vaccinations (24kb Word file)
• BCG referral (28kb Word file)

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Neurology

• Neurology specialist nurse referral (49kb Word file)
• Shared care update (90kb Word file)
• Treating acute relapses in a Primary Care - protocol for GPs
  (50kb Word file)

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Palliative care

• Anticipated need plan (32kb Word file)
• Do not resuscitate form - non Emis (38kb Word file)
• Handover care form (90 kb pdf file)
• Handover care form - non Emis (59kb Word file)

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Paediatrics

• BCG referral (28kb Word file)
• Enurisis service (36kb Word file)
• Outpatient referral form (29kb Word file)

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Radiology

• GP referral critiera issue 7 - January 2010 (40kb pdf)
• Imaging request form (EMIS) (270kb Word file)
• Imaging request form (non EMIS) (268kb Word file)
• Ultrasound referral pathway (90kb Word file)

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Rheumatology

• Back pain services referral form - EMIS (60kb Word file)
• Physiotherapy referral form - EMIS (40kb Word file)
• Rheumatology specialist nurse referral (49kb Word file)
• Rheumatology specialist nurse referral (non EMIS) (58kb Word file)
• Rheumatology nursing pathway (838kb Word file)
• Rheumatology nurse service information (837kb Word file)
• Rheumatology helpline service (835kb Word file)
• Rheumatology GP leaflet (227kb Word file)

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