Shaping better health
REMEDY : BNSSG referral pathways

Vascular Hot Clinic

Checked: 04-10-2018 by katy.kearley Next Review: 13-08-2019


The following advice is taken from the Directory of Services on eReferral:

Please refer patients with the following conditions as URGENT REFERRALS. They will be seen in the vascular HOT clinic (Southmead Hospital - which is now available via e-Referral but not directly bookable by GPs) or given an urgent clinic review in their local hospital:

• Symptomatic abdominal aortic aneurysm (AAA) - see red flags below.
• Asymptomatic large (>= 5.5 cm) or rapidly expanding (> 5mm in 6 months) AAA
• Symptomatic >= 70% carotid artery stenosis (TIA, Stroke or Amarosis fugax in last 6 months – patients presenting acutely should be referred to local TIA clinic who will refer to vascular service if appropriate.)
• Severe leg ischaemia (rest or night pain, arterial ulceration or tissue loss)
• Upper arm ischaemia – patients with dialysis fistula referred to renal access service
• Infected diabetic foot with vascular compromise (patients presenting acutely with diabetic foot ulcer may also be referred via local multi-disciplinary Diabetic Foot Clinic who will refer on to vascular service.)




The vascular HOT clinic is now on e-Referral but access is restricted to secondary care clinicians. GPs can only access this clinic by submitting an urgent vascular referral via eRS. The Referral Service had been reassured that these referrals are triaged by the vascular team  who will then contact the patient and see in the vascular HOT clinic if appropriate.

For more urgent advice or discussion please telephone the office (0117 4140798) or contact the on call general/vascular surgery registrar or vascular consultant on call via NBT switchboard (0117 9505050)

Please see the Vascular services - For clinicians page on the NBT website for further information.

Red Flags

All patients with suspected symptomatic AAA should be discussed  immediately via the on call vascular team at NBT.

If a ruptured AAA is suspected (classic triade of hypotension, abdominal pain or back pain and a pulsatile abdominal mass) then call 999 and liaise with on call vascular team at NBT.