Based at Southmead in the Brunel Building, Clinical Site Office.
GP's need to call the Medical Hub/Operational Centre for a telephone assessment to take place to refer a patient to the AEC.
For more information please look at the local information.
Local administrative information
The General Surgical and Urology Ambulatory Care service runs from Gate 35 Emergency Department Observation Unit (EDOU) (Previously Ambulatory and Emergency Care (AEC).
All patients for General Surgical ambulatory care will be booked into allocated time slots in a hot clinic through the Operations Centre.
1. All calls must go through the Operations Centre (Hub). The Surgical on call team will not accept direct calls.
2. Your patients will receive an allocated time slot to attend EDOU
3. If required, you will be responsible for booking the ultrasound scan on ICE.
IMPORTANT: in clinical history, please state ‘SURGICAL HOT CLINIC’
1. GP contacts Operations Centre (Hub) 0117 414 0700, patient identified for surgical ambulatory care
2. If patient requires USS, Hub confirms with GP to request scan on ICE stating ‘SURGICAL HOT CLINIC’ in clinical history
3. Hub enters patient details on electronic system; contacts Emergency Department Observation Unit (EDOU)
4. Receptionist in EDOU liaises with Hub and allocates patient to next available time slot
5. Surgical SpR on call is responsible for review of patients following Primary Nurse Assessment and investigations (USS).
NOTE: ULTRASOUND time slots are available Monday – Friday and Saturday and Sunday mornings only for Surgical Ambulatory Care patients for the following scans; Upper Abdo, Pelvic, Renal Tract, Testes and collections.
There are NO PROVISIONS for same day scanning of hernias. Patients requiring these scans are not suitable for the hot clinic and will need to be booked for an outpatient USS.
Admission avoidance pleural clinic (from mid-day Thursday or Friday only) on the Medical Day Unit. A weekly dedicated pleural clinic. A weekly thoracoscopy list. Indwelling pleural catheter insertion (usually as a day case procedure) and drainage support. Access to one of the most comprehensive portfolios of pleural research studies in the world, due to our current status as the largest pleural research unit in the country.
Who to contact:
If you need advice about a potential or known pleural patient, please contact either:
- The nurse specialist (Sarah Smith or Deborah Walton) on 0117 414 1010 or
- The pleural clinical registrar of the day on 07894 80 3088.
Referral letters to be faxed to:
0117 414 9481 or emailed to either
email@example.com, or firstname.lastname@example.org
Please remember to include anti coagulation information in any correspondence as this may influence the timing of interventions.
Referral Criteria & Guidelines Admission avoidance pleural clinic: Any patient with a symptomatic unilateral pleural effusion where an intervention will avoid hospital admission or allow fast track investigations into the underlying cause. These clinics are unsuitable for patients who are acutely unwell or bedbound. Information for Patients
The pleural admission avoidance clinic is held in the Medical day unit, Brunel building, Level 1, Gate 5, Southmead Hospital, Bristol, BS10 5NB. Please ask patients to check in at the gate reception desk on arrival. Parking is available at the multi-storey public car park and there is a patient drop-off in front of the main building.
Telephone 07500027385 to book patient into clinic or for advice then fax diabetes rapid access clinic referral form to 0117 9596379
This form is available on Remedy as a Word document under Referral Forms
Local administrative information
Active diabetic foot problems which are non-life or limb threatening to be referred to a multidisciplinary foot care service within 1 working day, for triage within 1 further working day. The local services are as follows, so refer accordingly to available services, or via A&E to the acute on-call team if appropriate, to meet the need of the patient;
Southmead Hospital; Has a joint diabetes consultant and podiatry clinics foot care service that operates every day, between the hours of 8 – 5pm. Staff usually see booked patients between 8 – 12am. There are two full MDT clinics per month. Referral to this service can be made by faxing a written referral to: 0117 414 9402 Faxes are triaged by the on call nurse for priority. If you wish to speak to the diabetes secretary please call: 0117 414 6422
Bristol Royal Infirmary; Has a joint diabetes consultant and podiatry clinics foot care service that operates Tuesday, Thursday and Friday mornings. There is one full MDT clinic per month. Referrals to this service can be made by faxing a written referral to: 0117 342 0279 Or leaving a message on: 0117 342 2175
Weston General Hospital; Has an MDT foot care service which operates every Tuesday morning. Please note that is not a hot foot clinic and therefore urgent referrals should only be sent within 48 hours of the clinic. If you need to make an urgent referral, please consider one of the other services described in this section.
From November 2016, all referrals should be made via e-referrals using the same process as that used for 2WW referrals.
Create the UBRN, select the speciality ‘Diabetic Medicine’ and clinic type ‘Podiatry and Foot’ and then select Weston Hospital and BOOK a dummy appointment.
Ensure you attach the new Diabetic Foot form at the same time so the trust can contact the patient.
Where possible, please attach a photo of the condition of the foot to the referral form in order to help the service prioritise the patient’s care.
The Respiratory Hot Clinic is based in the Ambulatory Emergency Care area within the Emergency Zone.
The Hot Clinic aims to facilitate same or next day assessment and treatment of respiratory patients in whom a specialist opinion may avoid a hospital admission. Patients referred via this route have timely access to imaging, physiology and specialist nurse assessment in addition to their medical review within the Emergency Zone.
The work of the Hot Clinic is complementary to the role provided by the Respiratory Specialist Nursing and Medical team in the Acute Assessment Unit (AAU) where daily patient review occurs 7 days per week. The aim of Respiratory AAU in-reach is to facilitate optimal patient care whilst focussing on early supported discharge.
GP referrals to the Hot Clinic are currently sent via fax to 0117 414 4125 and triaged by a dedicated respiratory nurse. Please ensure the patients contact telephone number is included on the referral form as, we will contact them by phone to give them an appointment time. Referrals may also be made from ED and AAU colleagues at North Bristol NHS Trust.
The service is available Monday to Friday (10am - 4pm).
The capacity of the Hot Clinic is up to 7 patients per day. When the slots are full, the consultant will consider the following options:
1. Discuss with the referring GP any possible management within the community or at home;
2. Book into a slot during the following couple of days where clinically appropriate;
3. Refer the patient to the AAU where the acute physicians would review the patient and manage in an ambulatory way (seeking clinical opinion from the respiratory team where applicable)
To facilitate the consultation, information is required on the reason for referral and a print out of the patients record from the GP notes system to provide details of the past medical history and current medications.
The respiratory consultant running the Hot Clinic will be available for opinion to GP colleagues and can be contacted via a dedicated mobile phone number (07713 391079) Mon - Fri 10am - 5pm
Care for the Elderly, Geriatric Clinic at Cossham Tepid Clinic referrals Telephone: 0117 4146443 Fax: 0117 4149457
The Operational Hub (see local info) will take calls and book appropriate patients into the urology HOT clinic which runs 7 days a week.
The HUB will inform the GP of the time slot for these patients.
Patients which are suitable for the HOT clinic are those who are ambulatory and are expected to be seen and discharged.
Local administrative information
If a patient needs to be urgently admitted to the Urology department at either Southmead Hospital or Weston General Hospital, please contact the hospitals as below:-
Weston General Hospital, please telephone 01934 636363 and ask switchboard to bleep the on-call Urology Consultant or Registrar to discuss admission.
Southmead Hospital, please telephone the Operational HUB on: 0117 4140700.
1.The HUB will take calls about patients who may need admission. Currently, these cases will still be discussed with the on call urology registrar (or surgical hospital at night team 12-7am) to agree the admission or potentially suggest an alternative. Sometimes, the urology registrar may not be able to answer the call while the GP is waiting and if this is the case they will be asked to contact the GP as soon as possible to discuss the patient and then inform the HUB if the patient is to be admitted.
2.The HUB will take calls and book appropriate patients into the urology HOT clinic which runs 7 days a week. The HUB will inform the GP of the time slot for these patients. Patients which are suitable for the HOT clinic are those who are ambulatory and are expected to be seen and discharged.
If admission is agreed as the best option, please give the patient a letter to take with them.
Monday to Friday mornings at the Major Arterial Centre (MAC) at the Brunel Building, Southmead Hospital for vascular patients requiring urgent review but not necessarily admission.
Patients can be referred via the new network office or by discussion with either the General Surgery/Vascular Surgery Registrar on call or the Vascular Consultant on call – see local information