Urgent 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:
stgh-tr.CancerReferrals@nhs.net

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

Rapid Access Paediatric Clinic referral form

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.

Downloads

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). After hours 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.

Downloads:

Emergency neurosurgery referrals

All emergency neurosurgery referrals to St George’s Hospital are to be made electronically via a secure on-line web system www.referapatient.org

Please access this webpage and select the ‘make a referral’ button and fill out the necessary information and clinical details. Once submitted, the on-call neurosurgery doctor will be informed of the referral by text and will review and respond at the earliest opportunity. The response will be received as a pdf letter which will be emailed to the (secure) address provided by the referrer.

Several referring teams have recently encountered difficulties opening this pdf file. We have been informed that this is being addressed, however in the short term, please consult the following advice: Referrers using an out of date Internet Explorer browser will have difficulty opening and downloading the referapatient® Advice Letter PDF because of compatibility issues with Adobe’s latest plug-ins. Several solutions exist:

  1. If you are using the Internet Explorer browser, go to Tools > Internet Options > Advanced. Scroll down to the security section and remove the check from the ‘Do not save encrypted pages to disk’.
  2. In Adobe Reader select Edit > Preferences > Internet, then uncheck ‘Display PDF in browser.’  PDF files will then open in Adobe Reader, not Internet Explorer.
  3. Right click the PDF link in email and copy the link. Open a new Internet Explorer window and click in URL bar, then right click and paste link.

If these all fail to help (depending on the last time Internet Explorer was updated) then please download Google Chrome.

If you wish to speak to a doctor whilst completing a  referral, please contact St George’s Hospital switchboard on 020 8672 1255 and ask for the ‘On Call Neurosurgery Registrar’ or access their bleep (7242) via the automated bleep desk. They may be unable to answer immediately if they are taking another call so please wait for a reply.

It is our experience that the transfer of scans for review can take some time. We therefore recommend contacting PACS transfer teams or radiographers depending on local policy to send any relevant imaging at the earliest opportunity via the Image Exchange Portal (IEP). If your case is urgent then please specify that these scans should be transferred as a ‘Blue Light Transfer‘.

Neurovascular MDT referrals

The Neurovascular MDT meeting takes place at 12:30am every Tuesday in the Atkinson Morley Wing, St George’s Hospital. It is attended by neuro-surgeons, neurologists, neuro-radiologists, stroke physicians and neurovascular clinical nurse specialists.

If you wish a patient to be discussed at the neurovascular MDT meeting you must fully complete the form below and e-mail back to stgh-tr.NeurovascularMDT@nhs.net.

Neurovascular MDT External referral form (Word)

Please send all relevant imaging via the IEP and the referral form by the Friday preceding (or in the case of bank holidays the Thursday) the meeting. The images and information need to be reviewed by a Consultant Neuroradiologist before the Neurovascular MDT.  It may not be possible to provide management and advice if a referral form and imaging are unavailable at the time of the meeting.

The Neurovascular CNS is available during working hours on 0208 672 1255 bleep 7711.

Metastatic Spinal Cord Compression (MSCC)

St George’s Hospital provides a 24 hour advisory service and surgical management for the patients with MSCC. We serve South West London (part of the London Cancer Alliance (LCA)) and the Surrey, West Sussex and Hampshire Cancer Network (SWSHCN).

MSCC is defined as spinal cord or cauda equina compression by direct pressure and/or induction of vertebral collapse or instability by metastatic spread or direct extension of malignancy that threatens or causes neurological disability.

The 24 hour contact number for the Lead MSCC Co-ordinator at St George’s Hospital is 020 8672 1255 and Bleep 6027

Referring clinicians/local MSCC Co-ordinators will be signposted by the Lead MSCC Co-ordinator/On-call Neurosurgical Registrar to access the South West London MSCC Service Referral Form. This is available here.

This form must be completed electronically and returned to the South West London MSCC Service.  The fully completed form should then be e-mailed to stgh-tr.mscc@nhs.net

In the event of server/system disruption or failure, this form should be printed off, completed manually and faxed back to 020 8725 4613.

A copy of the form should also be sent to the Cancer Centre at the same time to provide patient details to allow the Clinical Oncologist to initiate emergency radiotherapy if/once surgery has been excluded.

Please contact the Lead MSCC coordinator and the Clinical Oncologist (or AOS administrator at the local trust) to confirm how the form has been sent (i.e. fax or e-mail)