Referral routes into Secondary Care by Specialty and Clinic November 2017

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1 Referral routes into Secondary Care by Specialty and Clinic November 2017 C&B specialty Clinic / Comments Breast (from 7 th November 2016) (for other symptomatic see Surgery-Breast) July 2016 Referral route ENT (from 12th December 2016) RSS Haematology (from 9 th January 2017) RSS Lower GI (from 12th December 2016) RSS Lung (from 7 th November 2016) RSS 2WW Malignancy of Unknown Origin (from 9 th January 2017) RSS Malignant Lymph Nodes (from 12th December 2016) RSS Max Fax/Head and Neck (from 9 th January 2017) RSS Skin (from 25 th July 2016) RSS Urology (from 7 th November 2016) RSS Upper GI (from 4 th December 2017) RSS Gynaecology Direct to Allergy Allergy RSS Cardiology Children & Adolescent Services RSS Arrhythmia RSS Cardiology Genetics RSS Congenital Heart Disease RSS Heart Failure RSS Hypertension RSS Ischaemic Heart Disease RSS Lipid Management RSS Valve Disorders RSS Allergy RSS Audiology RSS Cardiology RSS Community Paediatric RSS Dentistry Orthodontics RSS Dermatology RSS Developmental/Learning Disabilities RSS Diabetes RSS Endocrinology RSS ENT RSS Gastroenterology RSS Gynaecology RSS Haematology RSS

2 Complementary Medicine Dentistry and Orthodontics Dermatology Diabetic Medicine Immunology RSS Metabolic Disorders RSS Nephrology RSS Neurology RSS Ophthalmology Not Otherwise Specified RSS Ophthalmology Orthoptics RSS Ophthalmology Strabismus/Ocular Motility RSS Oral and Maxillofacial Surgery RSS Orthopaedics RSS Other Medical RSS Plastic Surgery RSS Respiratory RSS Rheumatology RSS Surgery Not otherwise specified RSS Urology RSS Not referred via the RSS See pathway Not referred via the RSS Direct to Acne RSS Basal Cell Carcinoma (If lesion is on face consider RSS referral to Oral Maxillo-Facial) Connective Tissue Disease RSS Cosmetic Camouflage RSS Eczema and Dermatitis RSS Hair RSS Laser Clinics RSS Leg Ulcer RSS Male Genital Skin Disorders RSS Nails RSS Patch Testing for Contact Dermatitis RSS Psoriasis RSS Skin Surgery for Benign Lesions RSS Vulval Skin Disorders RSS Erectile Dysfunction RSS General Diabetic Management RSS Renal Diabetes RSS Diagnostic Endoscopy Please refer via GI and Liver (either Upper or Lower GI) Diagnostic Imaging Not referred via the RSS Direct to RSS

3 Diagnostic Pathology Not referred via the RSS Direct to Diagnostic Audiology RSS Physiological Echocardiography (To find Palpitation Clinical RSS Measurement Assessment Service) Dietetics Not dealt with by the RSS Direct to Balance/Dizziness RSS Ear RSS Facial Plastic and Skin Lesions RSS Ear, Nose & Throat Endocrinology and Metabolic Medicine General Medicine Hearing Tests/Aids search by Diagnostic RSS Physiological Measurement/Audiology Neck Lump / Thyroid RSS Nose / Sinus RSS Salivary Gland RSS Snoring (not Sleep Apnoea) RSS Throat (incl Voice / Swallowing) RSS Tinnitus RSS Adrenal Disorders RSS Gynaecological Endocrinology RSS Lipid Disorders RSS Metabolic Bone Disorders RSS Pituitary & Hypothalamic RSS Thyroid / Parathyroid RSS There is no General Medicine Clinic on Choose and Book for Scarborough Hospital. Please refer into the appropriate sub-specialty. Genetics Genetics RSS Genito-Urinary Medicine Geriatric Medicine GI and Liver (Medicine and Surgery) Not dealt with by the RSS. Open access patients Direct to service can refer themselves and information can be found at Cognitive Disorders RSS Falls RSS Metabolic Bone Diseases RSS Movement Disorders RSS Stroke (not TIA) RSS Colorectal Surgery RSS Gallstones RSS Hepatology RSS

4 Gynaecology Haematology Inflammatory Bowel Disease (IBD) RSS Lower GI (medical) excl IBD RSS Upper GI and Dyspepsia (including bariatric RSS surgery) Colposcopy RSS Family Planning RSS Infertility RSS Menopause RSS Menstrual Disorders RSS Pelvic Pain RSS Perineal Repair RSS Post-Menopausal Bleeding RSS Recurrent Miscarriage RSS Urogynaecology/Prolapse RSS Vulval and Perineal Lesions RSS Clotting Disorders RSS Haemaglobinopathies RSS Health Promotion Not referred via the RSS Direct to Immunology Autoimmune Disease RSS Immunodeficiency RSS Infectious Diseases Not referred via the RSS Direct to Interventional Radiology Not referred via the RSS Direct to Learning Disabilities Not referred via the RSS Direct to service Mental Health Adults of all ages Mental Health Child and Adolescent Nephrology Neurology Not referred via the RSS Direct to service Not referred via the RSS Direct to service Hypertension RSS Nephrology RSS Renal Diabetes RSS Cognitive Disorders RSS Epilepsy RSS Headache RSS Neuromuscular RSS

5 Neurosurgery Parkinsons/Movement Disorders RSS Stroke (not TIA) RSS Transient Ischaemic Attack RSS Movement Disorders RSS Spinal RSS Obstetrics Not referred via the RSS Direct to Occupational Therapy Not referred via the RSS Direct to service Ophthalmology Oral and Maxillofacial Surgery Orthopaedics Cataract RSS Cornea RSS Diabetic Medical Retina RSS External Eye Disease RSS Glaucoma RSS Laser (YAG Capsulotomy) RSS Low Vision RSS Neuro-Ophthalmology RSS Oculoplastics/Orbits/Lacriminal RSS Orthoptics RSS Other Medical Retina RSS Squint / Ocular Motility RSS Vitreoretinal RSS Facial Deformity RSS Facial Plastics RSS Head and Neck Lumps (not 2WW) RSS Oral Surgery RSS Salivary Gland Disease RSS Foot and Ankle RSS Fracture (non-emergency) RSS Hand and Wrist RSS Hip RSS Joint Injections (do not refer to Physiotherapy) RSS Knee RSS Limb Deformity/Reconstruction RSS Oncology (established diagnosis) RSS Podiatric Surgery RSS Shoulder and Elbow RSS Spine Back Pain (not Scoliosis/Deform) RSS

6 Orthotics and Prosthetics Spine Neck Pain RSS Spine Scoliosis and Deformity RSS Sports Trauma RSS Not referred via the RSS Direct to Pain Management Pain Management RSS Palliative Medicine Not referred via the RSS Direct to Physiotherapy Community Physiotherapy Rheumatology Physiotherapy Paediatric Physiotherapy (under 16 years old) Pregnancy/Women s Health Physiotherapy Blue Badge assessments Podiatry Physiotherapy ( ordinary musculoskeletal physiotherapy appointments). *Does not include Joint injections: for joint injections refer to Orthopaedics Community physiotherapy (patient homes and nursing homes) - for patients needing home assessments, falls or balance problems *Does not include Joint Injections: For joint injections refer to Orthopaedics RSS Direct to Service Not referred via the RSS Direct to Service Not referred via the RSS Direct to Service Not referred via the RSS Direct to Service Blue Badge assessments Direct to NYCC Podiatry (Spring Hill HDFT) Direct to Service Podiatry (Selby Podiatry in conjunction with Echo) Direct to Service Rehabilitation Not referred via the RSS Direct to Respiratory Medicine Rheumatology Sleep Medicine Allergy RSS Asthma RSS COPD RSS Cystic Fibrosis RSS Interstitial Lung Disease RSS Occupational Lung Disease RSS Tuberculosis RSS Bone / Osteoporosis RSS Inflammatory Arthritis RSS Musculoskeletal RSS Other Autoimmune Rheumatic Disease RSS Spinal Disorder RSS Excessive/Intrusive Sleepiness RSS Insomnia RSS

7 Speech and Language Therapy Sports and Exercise Medicine Surgery Breast Surgery Cardiothoracic Surgery Not Otherwise Specified Surgery Plastic Surgery Vascular Urology Parasomnia and Other Sleep Disorders RSS Sleep Apnoea/Sleep Disordered Breathing RSS Not referred via the RSS Direct to Not referred via the RSS Direct to FH of Breast Cancer (non 2WW) RSS Mammoplasty (non 2WW) RSS Oncology Established Diagnosis (non 2WW) RSS Other Symptomatic Breast (non 2WW) RSS Cardiac Surgery RSS Thoracic Surgery RSS Endocrine Surgery RSS Hernias RSS Lumps and Bumps RSS Basal Cell Carcinoma RSS Burns RSS Craniofacial RSS Gynaecology and Perineal Reconstruction RSS Laser RSS Lower Limb RSS Mammoplasty RSS Minor Plastic Surgery RSS Upper Limb RSS Vascular Malformation RSS Arterial RSS Leg Ulcer RSS Lymphoedema RSS Varicose Veins RSS (In) Continence RSS Erectile Dysfunction/Andrology RSS Haematuria (not 2WW) RSS Male Infertility RSS Prostate RSS Urinary Calculus RSS Vasectomy under local anaesthetic not on RSS Direct to service Currently carried out by Haxby Clinic or Doncaster

8 Vasectomy under general anaesthetic (cannot be referred to for a general anaesthetic unless IFR approval given. All vasectomy referrals should be done as local anaesthetic referrals direct to the primary care clinics) RSS

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