Urgent referrals to Epsom

This information provides an up to date guide to help the local GP community to better explain and ensure understanding of the urgent referral process at Epsom Hospital. We hope to improve and expedite urgent referrals to the appropriate speciality, and make local GP colleagues aware of the systems and services available that you can refer to if concerned.

We understand the difficulty in making referrals and getting in touch with the correct team in an appropriate time during busy clinics. If GPs have difficulty with obtaining contact with the correct speciality, it may result in patients sent to ED/SDEC without referral letters or referrals being made.

We in the ED and SDEC Department hope that this information assists and guides you in making you aware of the services available and the pathways to refer patients to the appropriate team.

Acute medicine

Specialty: Acute medicine
Contact details	Medical SpR - Bleep #848 If unavailable then contact the Medical Consultant on call via switchboard (020 8641 5565)
Patients accepted	Any unwell patient likely to need urgent admission Any patient discharged from medical ward within seven days if same condition / reason for presentation
Conditions accepted	Any primary medical condition
Other important information to include (if any)

Once accepted patient to be directed to ED with letter of referral addressed ‘Dear medics’

Same Day Emergency Care

Same day emergency care (SDEC) is a service that provides emergency care to people without the need for an admission to hospital. SDEC is one of the many ways the NHS is working to provide the right care in the right place for people and to improve flow in the emergency department

It encompasses emergency medicine and acute medicine teams working in SDEC.

The aim is to reduce admissions, improve flow in the ED, and for patients to see the right clinicians first time in the right place.

Patients will attend as walk-ins, via ambulance, referrals from 111, or GP referrals.

People with a NEWS2 score of less than 5 can be seen in SDEC.

For more details of the SDEC Gold Standard Pan London Pathways click here.

SDEC
Same Day Emergency Care
Patients accepted	All Stable patient, not requiring admission People with a NEWS score of less than 5
Example Conditions accepted	Suspected lower limb DVT Pulmonary Embolism (On hold) Cellulitis Pyelonenephritis Hyperemesis Gravidarum Suspected upper GI Bleed Low risk chest pain AKI (on hold) Atrial fibrillation Falls over 65 years

Contact details

Medical team in SDEC: acute medical consultant on mobile 07771 880880 Mon-Fri 9am-5pm

Outside of these hours please contact the Medical Specialist Registrar via switchboard 01372 735735 and bleep number 848.

Location

Both Out Patient SDEC and SDEC Medical Assessment Hub are located in the Bradbury Wing on the ground floor adjacent to ED reception

Hours of Opening:

SDEC Medical Assessment Hub – 24/7

Out Patient SDEC (Clinics) 8am to 5pm Mon to Fri

ENT

Specialty: Ear, Nose and Throat
Contact details	Contact ENT hub in working hours to arrange urgent review on 01372 735095
Patients accepted	Stable patient Patient requiring urgent review, but not likely to need admission
Conditions accepted	Otitis Media
Other important information to include (if any)	Appointments can be made for 24-48 hours Not available out of hours (OOH)

OOH patients should be directed to ED for assessment, consider directing patient to St George's Hospital if urgent ENT input required as not available at St Helier

Frailty phone service

Specialty: Frailty phone service
Contact details	Frailty phone 07880 130986 Only available Monday - Friday 8am - 5pm
Patients accepted	Frail patients (clinical frailty score 5-9) Those needing urgent assessment Not suitable for those requiring urgent medical admission
Conditions accepted	Frailty
Other important information to include (if any)

Gynaecology

Specialty: Gynaecology
Contact details	Gynaecology SHO: Bleep #832 8am – 5pm. After 5pm and at weekends please contact the obstetric team: Obstetric SHO - Bleep #833 Obstetric SpR - Bleep #829 Early Pregnancy Unit - 01372 735660 If unavailable then contact Gynaecology Consultant on call via switchboard
Patients accepted	EPU Stable patient Not pregnant or less than 15 weeks pregnant Gynaecology Stable patient Any patient discharged from gynaecology within 72 hours Any patient post op presenting within seven days
Conditions accepted	Abdominal pain of suspected gynaecological aetiology PV bleeding Persistent hyperemesis

Stable patients will be directed to EPAU

Unstable patient, likely to require immediate support and assessment will likely be directed to ED with letter addressed ‘Dear Gynaecology’

Haematology

Specialty: Haematology
Contact details	Haematology Consultant on call via Haematology POD on GP bypass number 020 8641 5565 ext 6098. Available Monday to Friday 8am - 5pm Haematology Lab SpR – Bleep 559
Patients accepted	Those needing urgent discussion Patients being transferred from RMH
Conditions accepted	Haematological malignancy Acute haematological pathology
Other important information to include (if any)	Any patient requiring admission must be discussed with Acute Medicine For non-acute problems we recommend the Advice and Guidance Facility on e-RS

Obstetrics

Specialty: Obstetrics
Contact details	Obstetric SHO - Bleep #833 Obstetric SpR - Bleep #829 Labour Ward: 01372 735208 If unavailable then contact the Obstetric Consultant on call via switchboard (020 8641 5565)
Patients accepted	More than 15 weeks pregnant with presentation related to pregnancy Any patient who is less than two weeks post partum with related issue
Conditions accepted	PV Bleeding Abdominal pain Reduced foetal movements Suspected pre-eclampsia Persistent Hyperemesis

Paediatrics

Specialty: Paediatrics
Contact details	Paediatric ED SpR - Bleep #762 If unavailable then contact the Paediatric Consultant on call via switchboard (020 8641 5565)
Patients accepted	Patient under 16 with any medical conditions Patients under 17 with acute mental health issues
Conditions accepted	Any medical conditions Well neonates with jaundice/prolonged jaundice should be discussed with postnatal SHO Bleep #766 (these patients should not attend through Paediatric ED)
Other important information to include (if any)	Surgical issues for patients five years and over should be discussed with surgical team at St Helier Patients under five with surgical issues should be discussed with paediatric surgeons at St George's Hospital Child protection medicals for non-accidental injuries (NAI) should be discussed with the duty social worker who should then discuss with the on call team for child protection. This is not appropriate for a Paediatric ED referral in most cases Non urgent advice and guidance is available via the eRS (electronic referral service)

Patients to be directed to ED with referral letter addressed ‘Dear Paediatric team’

Stroke

Specialty: Stroke
Contact details	Stroke Nurse - Bleep #971/#057 If unavailable then contact the Stroke Consultant on call via switchboard (020 8641 5565)
Patients accepted	Any acute stroke patient likely to require urgent treatment/admission Any TIA patient
Conditions accepted	Suspected Stroke TIA
Other important information to include (if any)	Hyper acute Stroke unit based at Epsom TIA clinic available seven days a week

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Urgent referrals to Epsom

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