REMEDY : BNSSG referral pathways

Surgical (SAU) HOT Clinic - NBT

Checked: 02-11-2018 by vicky.ryan Next Review: 02-11-2019

Service Overview

The SAU Hot clinic at Southmead Hospital is suitable for patients with general surgery or urology problems who might not require admission to hospital but who can be assessed in a private examination rooms, walk to radiology in the emergency zone and wait in a waiting area between investigation and review.

Referral Guidance

Referrals from GPs are made via Operations Centre (Hub): 0117 414 0700 for patients identified for surgical ambulatory care. The telephone call is taken by an experienced nurse. GPs will be asked for a full set of observations (to calculate a National Early Warning Score (NEWS) score). The nurse will then either:

  • Arrange a direct admission to SAU
  • Arrange an appointment in the appropriate hot clinic
  • Discuss the referral with a surgeon.

Patient leaflets regarding the referral are available on the NBT website.

The clinic is suitable for patients:

  • Over 16

  • Would otherwise be admitted to General Surgery as an emergency.

  • Are not systemically unstable

  • Have pain which can be controlled with oral analgesia

  • Who cannot wait for an urgent out-patient appointment or who cannot be dealt with by telephone advice from the on-call team

  • Patients who are potential readmissions for surgical site infections. These patients would have the following presentation:

    • Obstructive jaundice without sepsis  

  • Non specific abdominal pain

  • RIF pain but not obviously appendicitis

  • RUQ pain with suspected biliary colic/cholecystitis  

  • Acute rectal bleeding (usually these patients can be treated in out-patients but we can assess patients with bleeding that you are considering admitting)  

This clinic is NOT suitable for: 

  • Abscesses (these are assessed on the ward and treated as day cases)  

  • Patients who require a scan other than an abdominal scan. We cannot provide scans of hernias in this service  

  • Ischaemic limbs/cellulitis

  • Chronic pain that should be referred to a regular clinic  

  • Non GI/non abdominal problems

*Pregnancy must be ruled out before referring patient to the hot clinic*