REMEDY : BNSSG referral pathways

Early Pregnancy Assessment Clinic (EPAC)

Checked: 28-11-2017 by Rob.Adams Next Review: 28-11-2018

Service Overview

There are EPAC clinics at both St Michaels University and Southmead Hospitals.   EPAC is an emergency clinic for women with suspected miscarriage or ectopic pregnancy. 

To refer your patient, please follow the instructions on the referral form (see below)

For more information about the Early Pregnancy Clinic please see patient leaflet


Referral Guidance

Refer using the EPAC proforma. for referrals to both St Michaels Hospital or NBT.


  • A positive pregnancy test is mandatory (either GP or home test)

  • Early pregnancy more than 6+0 weeks and fewer than 18+0 weeks from LMP

  • Early pregnancy bleeding and/or pain


The patient must attend with a written referral. This can be a letter, scan request or fax, detailing the following:

  • Reason for attendance

  • Obstetric and gynaecological history, including LMP and contraception

  • Date of pregnancy test and blood group if known

On weekdays, there is no need to telephone as well. At the weekend, please telephone the SHO on call.

Cases not suitable for EPAC:

  • Unstable patients with severe bleeding and/or pain. Please refer to the on-call Gynae SHO for admission

  • Negative pregnancy test. Please refer to the GP, Emergency Department or on-call Gynae SHO

  • Postnatal patients. Please refer to the on-call Gynae SHO

  • Previous ectopic (and no pain and/or bleeding). Please refer to the Ultrasound Department at St Michaels University Hospital (0117 342 5347) or if booking at Southmead  (0300 555 0103)

  • Reassurance scan after previous miscarriage or for dating. Please refer to the Ultrasound Department - contact numbers as above.

Recurrent Miscarriage

Please refer to the Recurrent Miscarriage section of Remedy.