Referrals (advice and refer, formerly advice and guidance)
GPs wishing to refer a patient into some Barts Health services will need to do this through a process known as 'advice and referral' (A&R) using the advice and guidance (A&G) pathway on eRS.
Whilst nationally this service is still known as A&G, we refer to A&R to aid clarity in its purpose.
Any other referral pathways for these select services, such as DBS or RAS, are closed resulting in just one referral process. The change is being trialled across a number of specialties.
Information for NHS patients: understand your GP's approach to seeking advice and making a referral to hospital specialists.
eRS advice and referral service
Advice and referral (A&R) is for GPs and other referrers only. Please refer to the GP handbook for guidance on how to make an A&R request and for answers to some frequently asked questions.
Patients should use the contact details in their hospital appointment letter or information leaflet, or call the Trust switchboard .
The following services have switched to using only A&R:
- Cardiac arrhythmia
- Cardiac surgery (all hospitals)
- Cardio risk and lipids (all hospitals)
- Complex blood pressure and autonomic cardiovascular disorders (all hospitals)
- Difficult asthma (St Bartholomew's hospital)
- Elderly care (The Royal London, Newham and Whipps Cross Hospitals)
- Endocrine (Newham, St Bartholomew's and Whipps Cross hospitals)
- Gastroenterology (The Royal London Hospital)
- General paediatrics (Newham, The Royal London and Whipps Cross hospitals)
- General respiratory, including general asthma (St Bartholomew’s, The Royal London and Mile End Hospitals)
- Haematology (all hospitals)
- Haemostasis & thrombosis (all hospitals)
- Infectious diseases (all hospitals)
- Interstitial lung disease (St Bartholomew's, The Royal London and Mile End hospitals)
- Memory (Newham hospital)
- Paediatric trauma and orthopaedics
- Paediatric allergy (The Royal London)
- Plastics (all hospitals)
- Rheumatology (Mile End, The Royal London, Newham and Whipps Cross hospitals)
- Sleep (St Bartholomew's and The Royal London hospitals)
- Specialist breathlessness (Mile End Hospital)
- Thoracic surgery (all hospitals)
- Tuberculosis (Mile End Hospital)
- Urology (The Royal London, Newham and Whipps Cross hospitals)
GPs using A&R must select ‘advice’ on eRS. Before submitting the request, please give permission to the provider to allow for the request to be converted into a referral. Click ‘yes’ when prompted to do this.
The following services, separated by site, can all be accessed via eRS using advice and guidance (A&G), the directly bookable service (DBS) or the referral assessment services (RAS).
If the service you require is not listed above please contact them directly via the hospital switchboard.
Clinical consortia are being established for each speciality to evaluate the effectiveness of A&R. If you would like to take part, please contact Melanie Dalby.
Newham Hospital
- Cardiology
- Diabetic medicine
- General medicine
- Geriatric medicine
- GI and liver (medicine and surgery)
- Gynaecology
- Neurology
- Ophthalmology
- Respiratory medicine
- Surgery - breast
- Surgery - not otherwise specified
St Bartholomew’s Hospital
- Cardiology
- Diabetic medicine
- Gynaecology
- Pain management
- Surgery - vascular
The Royal London and Mile End hospitals
- Cardiology
- Dermatology
- Diabetic medicine
- Ear, nose and throat
- Geriatric medicine
- GI and liver (medicine and surgery)
- Gynaecology
- Immunology
- Neurology
- Oral and maxillofacial surgery
- Orthopaedics
- Surgery - not otherwise specified
- Surgery - plastic
- Surgery - vascular
Whipps Cross Hospital
- Cardiology
- Dermatology
- Diabetic medicine
- Ear, nose and throat
- GI and liver (medicine and surgery)
- Gynaecology
- Nephrology
- Neurology
- Ophthalmology
- Orthopaedics
- Pain management
- Respiratory medicine
- Sleep medicine
- Surgery - vascular
Contacting services not on eRS
Alternative contact details for services not using advice and refer are listed below. The details below should only be used for non-urgent queries where services are not using eRS. If the service you require is not listed above please contact the department directly via the switchboard.
|
Specialty |
Contact |
|---|---|
|
Breast surgery |
A&R provided by Newham Hospital (NH) for urgent cases only. Email advice provided by St Bartholomew's Hospital (SBH) |
|
Chronic Kidney Disease |
For urgent clinical questions, call the service on 02035945751, Monady-Friday, 8.30am to 5pm |
|
Geriatric |
Hotline at Whipps Cross Hospital (WXH) available 9am-5pm: 02085356644 |
|
HIV |
|
| Imaging | Email the service |
|
Maternity at Whipps Cross Hospital
|
Email the service |
|
Musculoskeletal services |
Email the service |
|
Nephrology |
Advice available via virtual CKD services, accessed through GP clinical systems |
|
Neurosurgery |
|
|
Paediatric rheumatology |
Please direct A&R requests to the paediatric general service |
|
Paediatric respiratory |
Please direct A&R requests to the paediatric general service |
|
Sexual health |
Email the service. Urgent sexual health including emergency contraception and HIV post-exposure prophylaxis can book a telephone appointment via All East. |
Urgent advice
The numbers below are direct contact numbers for specific services or appointment booking lines.
If the service you need is not detailed below or you are unable to get through, please contact the hospital’s switchboard.
Newham Hospital
-
Acute medicine (Gastroenterology, Hepatology, Neurology, Care of the Elderly, Memory, Tia /Stroke): 0207 363 9012
-
E ndoscopy: 0207 363 8042
-
Gynaecology: 02073639015, e mergency gynaecology unit: 02073638691
-
Haematology - a nticoagulation: 02073638730, g eneral haematology 02073639413, h aemoglobinopathy (Sickle cell and thalassaemia): 020 35941877
-
Maternity: 0207 3639302/8011
-
Oncology: 07930220095
-
Paediatric (children’s services): 02073639019
-
Specialist Medicine (endocrinology, diabetes, infectious disease, respiratory medicine, nephrology, infectious disease): 0207 3639013
-
Surgery (general surgery, colorectal, breast, sascular, ear, nose and throat, ophthalmology, paediatric ophthalmology, urology): 02073639021
-
Trauma and orthopaedics (and podiatry): 0207 3639022
Royal London Hospital and Mile End hospitals
-
Acute medicine: 020 3594 5642
-
Clinical immunology: 0207 377 7039
-
CWHS: 0207 377 7307 (for women going through EMA use 07720 948394)
-
Endoscopy: 020 3594 5743
-
Emergency gynaecology unit: 020 3594 1579 ( 8am-6pm, Monday to Friday, 8.30am-1.30pm on Saturdays. Call ward 8B outside of these hours)
-
General Surgery: 020 3594 5690/1
-
Geriatrics: 020 7377 7000 (extension 45799 via switchboard)
-
Gynaecology: 020 3594 5719
-
Gastro, IBS helpline: 0203 5943700, general enquiries: 020 3594 3400
-
Haematology - Haemophilia: 020 35941769, H aemoglobinopathy (Sickle cell and thalassaemia): 020 35941877, Anticoagulation: 020 35941885, Haematology Day Unit: 020 35941858
-
Hepatology - medical issues: 0207 377 7090, clinical nurse specialist: 0207 377 7088 between 9am-5pm)
-
HIV: 020 7377 7039
-
Neurology (on-call): 0203 594 5652
-
Neurosurgery (on-call): 0203 594 5649
-
Obstetric (on-call): 0203 594 5635
-
Oncology: 07715050735
-
Rheumatology: 0208 223 8859 (7.30am-4.30 pm)
-
Sexual health: 0207 377 7307
-
TIA/Stroke (on-call): 0203 594 5651/0203 594 5672
St Bartholomew’s Hospital
-
Cardiology - Arrhythmia: 0203 765 8646, General Cardiology: 0203 765 8715, Grown up congenital heart disease: 0203 765 8765, inherited cardiovascular disease: 0203 765 8611
-
Diabetes: 020 3594 6058
-
Fertility: 020 346 56093 / 55098
-
Oncology - 07940499062
-
All other services: 0203 765 8000
Whipps Cross Hospital
-
Appointment call centre (for all queries unless outlined below): 0208 535 6768
-
Breast clinic services: 020 8535 6933
-
General Surgery: 020 8539 5522, bleep number 2900
-
Gynaecology - emergency gynaecology unit: 0208 535 6499, gynaecology SpR: 020 8539 5522, bleep number 2203, obstetric SHO: 020 8539 5522, bleep number 2429, obstetric SPR: 020 8539 5522, bleep number 2430, gynaecology secretaries: 020 8539 5522, extensions 5181 and 6591.
-
Haematology - a nticoagulation: 020 8535 6815, g eneral haematology: 0208 535 6687, h aemoglobinopathy (sickle cell and thalassaemia): 020 35941877
-
Maternity: 020 8535 6861
-
Pain: 020 8539 5522, extension 5360
-
Paediatric Services: 020 8539 5522, bleep number 2137
-
Oncology: 07703469211
-
Ophthalmology: 020 8539 5522, extension 6888
-
Eye Casualty Reception, extension 5715
-
Eye Casualty Mobile: 079 7165 5894
-
-
Urology: 020 8539 5522, bleep number 2500
Exceptions
Referrals
Please use the NHS e-Referral Service (eRS) for all GP referrals into Barts Health, including urgent two week waits.
Information and links to referral forms can be found on the dedicated webpage.
Written and exception referrals
Some specialist or urgent services may be exempt from Paper Switch Off. Please check our website page on a regular basis for details.
Urgent cancer referrals
All cancer two week wait services are available on eRS and must be sent this way.
Urgent care centres, out-of-hours primary care providers, hospital clinicians, dentists and optometrists are advised to use the MS Word version of the Pan-London Suspected Cancer Referral Forms to refer patients with a suspected cancer. When referring a patient, a copy should also be sent to the patient’s GP.
Dental referrals
To help dentists refer to our services, we have set out careful guidelines and special referral forms which must be read carefully and used appropriately.
Information on clinical consortium
Here at Barts Health we want to work collaboratively with our ICB colleagues and primary care to evaluate and further improve our advice & refer services. We have set up clinical consortia for each of the larger specialties that have switched to do this. If you are a GP or member of staff at a GP practice and are interested in joining our consortia please contact Melanie Dalby (melanie.dalby1@nhs.net). You are welcome to join as a member or attend on an ad hoc basis. Details of the different consortia we have set up and the next set of dates are below:
Gastroenterology consortium |
|
|
|
Date |
Time |
Venue |
| 13th March | 11:00 - 12:00 | Microsoft Teams |
| 12th June | 11:00 - 12:00 | Microsoft Teams |
| 11th September | 11:00 - 12:00 | Microsoft Teams |
Endocrine Consortium |
|
|
|
Date |
Time |
Venue |
|
1st March |
11:00 – 12:00 |
Microsoft Teams |
|
3rd May |
11:00 – 12:00 |
Microsoft Teams |
| 5th July | 11:00 - 12:00 | Microsoft Teams |
General Paediatrics Consortium |
|
|
|
Date |
Time |
Venue |
|
7th March |
14:30 – 15:30 |
Microsoft Teams |
|
2nd May |
14:30 – 15:30 |
Microsoft Teams |
| 4th July | 14:30 – 15:30 | Microsoft Teams |
Rheumatology Consortium |
|
|
|
Date |
Time |
Venue |
|
27th January |
14:00 – 15:00 |
Microsoft Teams |
| 17th March | 14:00 – 15:00 | Microsoft Teams |
| 19th May | 14:00 – 15:00 | Microsoft Teams |
Haematology Consortium |
|
|
|
Date |
Time |
Venue |
|
16th January |
10:00 – 11:00 |
Microsoft Teams |
|
20th February |
10:00 – 11:00 |
Microsoft Teams |
|
20th March |
10:00 – 11:00 |
Microsoft Teams |
The rules for requesting radiology exams in Millennium are changing
If you refer patients for any diagnostic imaging, you must have the appropriate IRMER training in line with regulations.
From 1 April 2023, non-medical clinical staff need to have completed their training and had their application approved by the radiology team to continue referring patients for imaging services. This includes people who make referrals to our service from outside Barts Health. This change is being made so that we are compliant with the law.
How can I make referrals?
All authorised staff will be granted automatic access to imaging referrals via CRS.
However, non-medical referrers must be registered with a professional healthcare body and successfully completed training. Access will then be granted on an individual basis by the radiology team when you submit your Non-Medical Imaging Referral Application form[docx] 24KB.
Some groups of staff are not covered by legislation to make ionising referrals, including physician associates, medical secretaries and admin staff. Teams will need to ensure that there are registered referrers in place to make these referrals following the formalised change on 1 April.