UHL/LRI SPECIFICS
Where are the different specialities based, and how to refer:
As previously mentioned, UHL consists of three main hospital sites - Leicester Royal Infirmary (LRI), Leicester General Hospital (LGH) and Glenfield Hospital (GGH) - with the different specialities spread across these.
Speciality referrals are largely done via an ‘e-referral’ on Nervcentre, although there are some exceptions. Please also bear in mind that if a patient is more unwell/unstable and requires immediate input, an e-referral is not an appropriate way of contacting the speciality team and you should be contacting the team more urgently through an alternative means (i.e. phoning/bleeping/’fast bleeping).
The table below outlines where each speciality is based within UHL (and those outside of UHL such as Neurosurgery), as well as how to make routine referrals.
STEMI Alert - When a STEMI has been identified, phone 3222 to put out a STEMI alert. The full procedure to follow is highlighted here.
RAP Call - This is an alert for a suspected or confirmed acute stroke. Phone 2222 to put out a RAP call. Again, the pathway to follow can be found here
Hand Injuries - Referral of hand injuries differs depending on the day. From Monday (08:00) - Friday (08:00), referrals should be made to Orthopaedics. From Friday (08:00) - Monday (08:00), referrals should be to Plastic Surgery.
‘Watershed’ Conditions - These are conditions/injuries where management of the patient could fall between referral to two different speciality teams. For any queries, please see the UHL guidance on this here.
Alternative Services:
GPAU (Adults Only): This is run by the General Medical team and is located on level one of the Balmoral Building, next to WHSmiths. Here, patients can receive a medical (and possibly even a speciality (e.g. neurology, rheumatology)) review, along with any investigations and treatment that they may need, with the aim of discharging these patients in less than 24 hours. Please click here for some guidance on appropriate issues/presentations that can be referred to GPAU. Referral is done via e-referral on Nervecentre.
SDEC (Adults Only): This is based at GGH and has a similar function to GPAU, but is instead geared towards cardiology and respiratory issues. Again, referral is via Nervecentre. Please see criteria for referring to SDEC here.
Surgical Triage (Adults Only): Patients can be referred to Surgical Triage for same day surgical review. Examples of presentations that may be appropriate include RIF pain (pregnancy must be excluded), abscesses (excluding breast) and post operative wound problems. Patients should be referred through the General Surgeons on Nervecentre.
MIaMI (Adults and Children): MIaMI stands for Minor Injuries and Minor Illnesses and is a GP led service which provides urgent and assessment of patients with minor illnesses/injuries who could be treated in a GP practice of urgent care centre. Patients will ordinarily be triaged here soon after arrival (from the VAC desk or following initial triage).
Eye Casualty (Adults and Children): This is open Monday-Friday from 08:30-16:30 and 08:30-12:30 at weekends and on bank holidays. Eye Casualty is located on Level 1 of the Windsor Building.
Please use your clinical judgement when determining whether a patient is suitable to go to any of the above services, and ensure that they are clinically stable prior to sending them.
Clinic Referrals:
DVT Clinic: Patients with a suspected DVT, and who are safe to be discharged, can be referred to the DVT Clinic. Please see here for the DVT pro-forma which will explain the process.
PE Clinic: Patients with a suspected PE, and who are safe to be discharged, can be referred to PE Clinic via ICE.
Fracture Clinic: Fracture Clinic referrals can be completed on ICE. Please note - if you have ‘found’ a fracture, then you are responsible for completing this referral, regardless of whether the patient is being admitted or not. Patients with fractures are often admitted under e.g. the medical team, meaning that there is a risk that they will not be referred and therefore will not be appropriately followed up.
First Fit Clinic: For those who have had what is suspected to be their first seizure, referral to First Fit Clinic is also done via ICE.
Paediatric Outpatients: To refer paediatric patients for outpatient follow up, please follow the instructions here.