GP information

Urgent referrals

Changes to the way appointments are booked at St George's

Rapid Cancer Referrals
Other urgent cancer referral methods
Urgent Breast referrals
Rapid Access clinics and urgent referrals
Rapid TIA/Mini Stroke referrals
First Fit referral
Neuro-oncology MDT referrals

Rapid Cancer Referrals

For urgent referrals of suspected cancers, a specific urgent referral form should always be used. Copies of the form are available from the Trust's Two Week Referral (TWR) office by calling 0208 725 1111.

It is important that you complete the form as fully as possible. This will help minimise any delay once we receive it.

The forms should be faxed to our Two Week Referral (TWR) office within 24 hours of your decision to refer the patient. We will ensure the patient is given an appointment within 14 days.

The fax number for urgent referrals is 0208 725 0778

This should always be your first point of contact for an urgent suspected cancer referral.

Please try to ensure that the patient's details, demographic data, NHS number, clinical history and contact information are written clearly, that the forms are as complete as possible, and please submit the form to us within 24 hours. Please include any relevant information in additional sheets or a letter. Please also indicate whether an interpreter is required.

As you will appreciate, it is important that we see the patient as quickly as possible.

You or your colleagues will need to organise transportation. For further advice and information please call us on 0208 725 1777.

Other urgent cancer referral methods

While faxed referrals on standard forms are the preferred form of referral, we will also accept letters addressed to the Two Week Referral Office. Please indicate in the letter that the patient is being urgently referred with a suspected cancer. It is then advisable to fax this letter straight through to the above fax number. Posting the letter will add a further delay to the process, but you can post the referral letter as confirmation of your original fax. Our postal address is:

TWR Office
St George's Hospital
Blackshaw Road
Tooting
London SW17 0QT

Referrals can also be emailed directly to the office at: cancerreferraloffice@stgeorges.nhs.uk

Urgent Breast referrals

If you have an urgent or suspected breast cancer referral, please fax your referrals to the Breast Office on 020 8725 3466.

GPs should obtain the relevant referral form from:

Mr. Alastair Johnston
Wandsworth Primary Care Trust
Teak Tower, Main Building
Springfield University Hospital, 61 Glenburnie Road
London SW17 7DJ

Tel: (020) 8682 5835; Fax: (020) 8682 5846

Email: alastair.johnston@swlondon.nhs.uk.

Rapid Access clinics and urgent referrals

We also provide a number of fast-track clinics to which referrals may be made directly by fax or telephone. Other specialties have specific arrangements for urgent referrals:

Rapid Access Chest Pain Clinic	Tel 0208 725 2532 Fax 0208 725 1085
Rapid Access Paediatric Clinic	Tel 0208 725 2539 Fax 0208 725 1724
Urgent neurosurgical cases	Please bleep the on-call Neurosurgery Registrar On bleep 7242.
Fracture Clinic	Please fax referrals to 0208 725 3271, or ask the patient to attend A&E with a GP letter
Pathology results	For urgent updates please call our GP pathology hotline on 0208 725 0099/5470

Rapid TIA/Mini Stroke referrals

Please note the new pathway for referring patients with TIA to St George's Stroke Service and Rapid Access TIA clinic from October 2012 onwards.

Referring patients with stroke

If the patient still has a deficit when you assess them, they should be referred to St George's Hospital Accident and Emergency (A&E) via the ambulance service.

Referring patients with TIA

High risk patients

We aim to investigate and treat people with High Risk TIA on the same day. We aim to review all other people who have had a definite TIA in the last 7 days within 24 hours of referral.

Please use the High Risk Referral Pathway if:

The patient has had more than one TIA
The patient's TIA was within the last 48 hours and their ABCD2 score is ≥4

Methods of referral are:

High Risk Patients:Contact the Stroke Consultant immediately on 0782 693 4376 (Monday to Friday, 09.00hrs-18.00hrs) or bleep the Stroke Registrar via St George's hospital switchboard on 020 8672 1255
All other patients with definite TIA: fax referral form on the same day you see the patient to 020 8725 4591 (Monday 08.00hrs to Friday 16.00hrs) and mark urgent

When diagnosis of TIA is uncertain

We aim to investigate and treat these people within 7 days.

Method of referral is:

Fax referral form to 020 8725 4591 (Mon 08.00hrs to Friday 16.00hrs)

Phone Advice

If you are uncertain about the best management of a patient with a suspected TIA, you may speak to a Stroke Consultant directly on 0782 693 4376 (Monday to Friday, 09.00hrs-18.00hrs). Afterhours and at weekends please call the Stroke Registrar via the hospital switchboard on 0208 672 1255. Please note - this phone number is for GP use only. Patients who phone this number directly will be advised to phone their GP surgery.

First Fit referral

For urgent referrals for suspected first fits we offer a rapid access clinic. The First Fit Referral form should always be used can be downloaded or requested by calling 0208 725 4107.

Download the First Fit Referral Form

Referral forms can be faxed directly to the Neurology Department on 0208 725 4591 or e-mailed to the department at the following address: adult.epilepsy@stgeorges.nhs.uk. Please ensure that the patient details, clinical history and contact information are correct and that the forms are as complete as possible. As you will appreciate it is important that we see the patient as quickly as possible.

Patients should be advised to bring someone who witnessed the suspected first fit or the contact details of that witness.

We also provide a Suspected First Fit Patient Information sheet which can be given to the patient at the time they are referred.

Download the Suspected First Fit Patient Information sheet

For further advice and information please call 0208 725 4107.

Neuro-oncology MDT referrals

In line with the ‘Improving Outcomes for People with Brain and Other CNS Tumours’ (DoH, 2006), all patients with suspected or confirmed brain or spinal tumours (benign or malignant) within the South West London Cancer network (SWLCN) or Surrey, West Sussex and Hampshire cancer network (SWSHCN) must be discussed at the neuro-oncology specialist multi-disciplinary team meeting (SMDT).

This SMDT meeting takes place at 8:30am every Friday morning in Atkinson Morley Wing, St George’s Hospital. It is attended by neuro-surgeons, neurologists, neuro-radiologists, neuro-pathologists, orthopaedic surgeons, neuro-oncology clinical nurse specialists and clinical oncologists from both the Royal Marsden Hospital and Royal Surrey County Hospital.

Please fully complete the form below and e-mail back to stgh-tr.neuro-oncologyMDT@nhs.net in order to submit a patient for discussion at this meeting.

Please ensure that you include a contact number to allow the clinical decision to be fed back to you following this meeting.

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