Referrals & forms

Cancer Rapid referral guidelines

Referral for suspected DVT

Paediatric Bladder and Bowel Care Service

Referral form

Referral form for General Surgical Emergency Clinic

Referral form for General Surgical Emergency Clinic (pdf)

Please send to: ndht.cmcnewappointments@nhs.net

Community speech and language therapy referral form

This form is for community referrals only.  For community hospital in-patients, please continue to refer to the local therapist.

Community speech and language therapy referral form

Urgent two week referrals for suspected cancer

Patients that do not meet the referral criteria for direct access OGD, flexible sigmoidoscopy or the bidirectional endoscopy (OGD and colonoscopy) service for IDA need to be referred using the Colorectal Cancer (CRC) referral form or to Gastroenterology depending on the clinical scenario. This will allow for clinical assessment of the patient before proceeding to endoscopy. The Trust will be working with the clinical teams regarding the new NICE referral guidance and will ensure developments/progress is communicated as it becomes available.

Please ensure that all patients being referred with suspected cancer have recent FBC’s and U&E’s available- thank you.

Forms located on the North & East Devon Formulary and Referral site

Paediatric cancer care (patients under 18 years)

Open Access Flexible Sigmoidoscopy

Open Access Gastroscopy and Colonoscopy for Investigation of Iron Deficiency Anaemia

Open access Upper GI endoscopy

Suspected Head and Neck Cancer Referral Guidance – January 2016

Further to recent communications, suspected cancer ENT and Thyroid referrals need to be referred to the Royal Devon and Exeter using the forms below. These referrals will need to be made through the e-referral system as Royal Devon and Exeter do not accept faxed referrals.

Northern Devon Healthcare Trust will continue to receive suspected cancer referrals for Maxillo-Facial referrals which will be received in the usual manner; either e-referrals or via Fax.

ENT and Thyroid referral Forms – RD&E

ENT

Thyroid

Maxillo-Facial referral Form – NDDH 

Max Fax

Haematology Referral and Advice Sheets

Anaemia in Adults

Chronic Lymphocytic Leukaemia

Lymphocytosis

MGUS

Neutropenia

Neutrophilia

Thrombocytopenia

Thrombocytosis

Proformas:

Referral Form to the Rapid Access Chest Pain Clinic with referral notes (pdf)

Suspected Heart Failure referral proforma (pdf)

Direct Access Echocardiography Request form (pdf)

Orthoptics service

Children’s Rapid Access eye clinic operational policy (pdf)

Guidelines Paediatric referral to the Orthoptist (pdf)

Guidelines for Adult referrals to the Orthoptist (pdf)

All GPs have been issued with a username & password to access some of the content on these pages. If you need a password reminder please contact lucy.parr@nhs.net or jamesrowles@nhs.net
Referral to the Orthoptist (pdf)

Diabetes Foot Pathways