Northumbria Specialist Emergency Care Hospital, Cramlington

Transcription

1 GP Referral Guide Information about patient pathways following the opening of Northumbria Specialist Emergency Care Hospital in Cramlington on 16 June 2015

2 Northumbria Specialist Emergency Care Hospital, Cramlington Helipad Ambulances Children s unit Level 2 Assessment unit and medical ambulatory care Level 1 Birthing Centre Level 2 Emergency care Level 1 Special care baby unit Level 2 Theatres Level 2 Critical care Level 2 Wards 4, 10, 16 Level 2 - maternity (16) Level 1 - cardiology (10) Ground - gastroenterology (4) Wards 1, 7, 12 Level 2 - respiratory (12) Level 1 - acute medical unit (7) Ground - trauma (1) Wards 3, 9, 15 Level 2 - surgical assessment unit (15) Level 1 - elderly care/stroke (9) Ground - surgery (3) Restaurant Ground Car parking Entrance Level 1

3 Where will emergency patients be treated when the new Northumbria Specialist Emergency Care Hospital opens on 16 June 2015? The aim of this referral guide is to provide you, as a GP, with an overview to where your patients will go to ensure the right care, in the right place, at the right time. From 6am 16 June 2015, all serious medical emergencies or life threatening conditions will go to the new Northumbria Specialist Emergency Care Hospital in Cramlington, where we will have 24 hour emergency care consultant presence, as well as specialists in a range of conditions working seven days a week. This includes conditions such as suspected stroke, loss of consciousness, chest pain, shortness of breath, severe abdominal pain, sepsis or severe blood loss. All emergency surgery will take place at the new, as well as some high risk procedures. In these circumstances people should go straight to the by emergency ambulance, GP referral or self-present if they are able to. For less serious but urgent conditions, people will have the choice of either attending their local GP surgery or going to the 24 hour walk-in services at Hexham, and general hospitals, or their local community hospital. This will be for minor conditions such as sprains, strains, cuts and bites, children s minor injuries and ailments, minor fractures or broken bones, minor head, ear or eye problems, broken noses and nose bleeds, abscesses and wound infections. We will keep you informed of updates via our bulletins and dedicated app for GPs or Ciix website: gp.northumbria.nhs.uk To watch our video: A new era in emergency care, please scan the QR code with your smartphone.

4 Keeping you informed We will continue to aid your referral decisions by producing a number of regular updates including: GP UPDATE NEWSLETTER NEW MODEL OF EMERGENCY CARE You may be aware that earlier this month we launched the first phase of a public awareness campaign to communicate changes to our emergency care services once the Northumbria Specialist Emergency Care Hospital opens in June. The campaign aims to ensure that people living and working across Northumberland and have all the information they need about the emergency care changes coming in June and that they understand how to access services depending on their condition. This is an important public information campaign to ensure people understand the changes taking place and come to the right place for the right treatment. We will be working closely with clinical commissioning group colleagues to ensure that this is sitting alongside the wider regional messages about choosing the right care at the right time, whether that is self-care, pharmacy, GP or hospital. Bus and radio adverts have already begun and we have launched a new website - As it comes close to the opening, we will be building on this campaign with high profile communications across transport networks, household leaflet distribution and continued media coverage and social media activity. URGENT CARE 24HR WALK-IN SERVICES or call 111 for advice. GO TO - 24 hour walk-in services at Hexham, and hospitals SERIOUS EMERGENCIES NEW HOSPITAL CRAMLINGTON for an emergency ambulance. GO TO - Northumbria Specialist Emergency Care Hospital in Cramlington or call 999 A NEW ERA The result of ten year s work led by clinical teams at Northumbria Healthcare will be realised in June when the new specialist emergency care hospital opens in Cramlington, changing the way emergency care is delivered across Northumberland and. In this special edition of our GP magazine you will find information on pathology, medical ambulatory care and elderly care, and how the changes to emergency care put the North East ahead of other parts of the NHS. KEEPING YOU INFORMED We know that you will have lots of questions as it gets close to the new hospital opening, and over the coming weeks we will be producing materials for you to aid your referral decisions. This will include specialty-specific pathways, updated advice lines and we will also be updating Ciix, our dedicated app for GPs. This can be download for IOS and android devices on the QR codes below. For android: For IOS: We will be keeping you updated through our bulletins and magazines via . If you don t currently receive these but would like to, please provide us with your address by contacting our communications team at communications@northumbria.nhs.uk We have produced some Q&As for GPs about the changes - if you require a copy please contact our communications team at the address above. GET IN TOUCH We welcome any questions you may have about these changes - please contact us at nsech.gps@northumbria.nhs.uk If you would like to look around the new Northumbria hospital please book a place by contacting us at the address above. March 2015 GP UPDATE BULLETIN We will keep you informed with this fortnightly bulletin regarding any updates and operational changes. If you don't currently receive this please contact us on: communications@northumbria.nhs.uk to be added to the distribution list. GP APP We will also update Ciix, our dedicated app for GPs. This can be downloaded for IOS and android devices on the QR codes opposite, or go to gp.northumbria.nhs.uk For non-clinical general enquiries, nsech.gps@northumbria.nhs.uk For android: For IOS:

5 GP hotline We have introduced a direct phone line for GPs for emergency admissions and to provide acute advice and guidance on where to send patients - call (0191) The diagram opposite shows how your call will be directed through to the appropriate service. GP Dedicated line for GPs Do you need...? Definite admission Northumbria Specialist Emergency Care Hospital Medical ambulatory care (Northumbria Specialist Emergency Care Hospital) Surgical assessment unit (Northumbria Specialist Emergency Care Hospital) Elderly assessment centre (Hexham, and hospitals) Acute specialist advice Community services Medical specialties Surgical specialties Children Radiology Accident and emergency Acute medicine Cardiology Care of the elderly Diabetes Gastroenterology Haematology Old age psychiatry Oncology day unit Palliative care Rheumatology Respiratory Stroke General surgery Gynaecology Maternity Orthopaedics

6 From 6am 16 June 2015, the following information applies to patient pathways

7 Northumbria Specialist Emergency Care Hospital Acute Medicine/Medical Ambulatory Care (MAC) Medical Ambulatory Care (MAC) All new patient referrals will be seen at the (see below) Follow-ups may be seen at the Northumbria hospital or at our general hospitals Continue present work of pathway patients : Stable new fast AF, PE, DVT, Cellulitis, Anaemia Bigger focus on non-pathway patients: - any patient with a medical problem who is stable and ambulant should be considered for medical ambulatory care GPs will be able to phone in and discuss referral straight into MAC for non-pathway patients as they do at present. We will be able to take a much larger range of acute patients due to increased medical cover, same day imaging and extended opening times Same day diagnostic imaging preventing need for re-attendance Northumbria Specialist Emergency Care Hospital 8am-8pm (7 days) Outside of these times referrals through acute medicine unit pathway (see below) Enhanced service with extended 7 day opening times Consultant cover from 10am-8pm (advanced nurse practitioner from 8am). From 8pm-midnight advice is available from medical consultant in Acute Medicine Unit (AMU) Dedicated direct referral and advice phone numbers for acute medical and ambulatory care am-8pm (advanced nurse practitioner 8am-10am, consultant available 10am-8pm) Or refer to the Northumbria hospital through the GP hotline Acute Medicine Unit (AMU) Specialty acute medicine ward Run by acute care physicians, with input from GIM consultants out of hours Conditions which are specific to the unit include: sepsis, AKI, diabetic/endocrine emergencies, infectious diseases, toxicology, non-stroke neurology, haematology/oncology emergencies We will continue to take a range of GIM patients, with a focus on those who have a quick turnaround to discharge time Northumbria Specialist Emergency Care Hospital At present all admissions to medicine come via the emergency care unit at General Hospital or the medical admissions unit at. At the patients will go straight to specialty ward, AMU is a specialty ward in its own right. Admission of patients via the emergency department at the Northumbria hospital. Refer through the GP hotline Consultant cover on-site from 8am - midnight

8 Existing hospitals Acute Medicine/Medical Ambulatory Care (MAC) continued Medical Ambulatory Care (MAC) Services at and general hospitals for review patients only At Hexham the existing DVT pathway continues unchanged; otherwise review patients only The service at all three general hospitals will be run by ambulatory care advanced nurse practitioners. Senior medical cover provided by telelink to the Northumbria hospital if required All new referrals must come to the Hexham General Hospital Monday-Friday 9am-12noon Monday-Friday 9am-12noon Monday-Friday 8am-4pm No new referrals as all same day diagnostics will happen at the DVT pathways unchanged for Hexham Referrals through MAC at the Or call the GP hotline Hexham call /7 for DVT referrals Acute Medicine/Medical Ambulatory Care (MAC)

9 Northumbria Specialist Emergency Care Hospital Cardiology Acute admissions All acute emergencies will go to the emergency department at the Only exception - if an ambulance is called to the patient s home with an ST elevation heart attack, in which case the patient will go straight to the Freeman Hospital in Newcastle If non ST Segment Elevation Myocardial Infarction then the patient can go to the Northumbria Specialist Emergency Care Hospital No change to current referral pathways, but if concerned, for example a patient with chest pains, refer to the Northumbria hospital as a GP admission For advice or to refer to the, call the GP hotline

10 Existing hospitals Cardiology continued Outpatients For, and Hexham general hospitals: no change to existing referral pathways Patients presenting with suspected cardiac conditions including arrhythmia, heart failure, hypertension, ischemic heart disease and valve disorders Hexham As current No change to existing referral pathways Referral information: via Choose and Book or fax referral to Or call the GP hotline Diagnostics : Patients suspected of suffering an AMI should be admitted via the Those requiring cardiology open access ECG, BP and echo should use this service : Those requiring cardiology ECG, Holter monitoring, ABP and echo appointment should use this service Hexham : Patients suspected of suffering an AMI should be admitted via the Those requiring cardiology ECG, ABP and Holter monitoring should use this service Hexham As current Referral via fax Referral via fax Referral via fax Or call the GP hotline Cardiology Rapid access chest pain clinics These will continue as at present at, Hexham and general hospitals Referral via fax Referral via fax Hexham Referral via fax Or call the GP hotline ECG drop-in service at Patients who would benefit from an ECG can use this service. If GPs have any significant concerns send the patient to the or discuss with the on-call cardiologist Patients suspected of suffering an AMI should be admitted via the If GPs have any significant concerns refer to the, or discuss with the on-call cardiologist, through the GP hotline

11 Northumbria Specialist Emergency Care Hospital Child Health Children with acute medical conditions should be referred to the Short Stay Paediatric Assessment Unit (SSPAU) at the A small proportion of these children may be transferred to the Great North Children s Hospital (GNCH) if they are expected to need more than one night in hospital SSPAU at Northumbria Specialist Emergency Care Hospital 7 days NEAS bypass policy is in place for paediatrics between 11pm and 8am Refer to the paediatric department at the through the GP hotline If you need urgent advice about a child s diagnosis or treatment you can speak to the consultant paediatrician on duty at the, or senior doctor or nurse practitioner overnight SSPAU at Northumbria Specialist Emergency Care Hospital 9am-9pm - consultant, 9pm-9am - senior doctor or paediatric nurse practitioner Please call the paediatric team through the GP hotline If a child needs an urgent outpatient assessment, they can be seen by a consultant in the next few days at, or Hexham general hospitals Hexham Monday to Friday 9am-5pm Fax a referral to

12 Existing hospitals Child Health continued Children already under the care of specialist services at GNCH and who require specialist treatment should be referred to GNCH Great North Children s Hospital, Newcastle upon Tyne No change to existing referral pathways Children with minor injuries (e.g. broken bones, lacerations, minor head injuries) can still be seen at the walk-in services at, and Hexham general hospitals Routine blood and X-ray investigations will continue to be carried out at and general hospitals Hexham Monday-Friday 9am-5pm X-rays - no change, refer to local radiology service at or general hospitals Referrals have been centralised and blood clinics will be delivered in a clinical setting as close to home as possible depending on the urgency of the request Self-presentation, or for advice, or to refer, call the GP hotline Blood clinic: or referral via fax Or call the GP hotline Child Health The Child and Adolescent Mental Health Services (CAMHS) will remain at Albion Road and Balliol Newcastle Tyne and Wear Mental Health Care Trust (NTWMHC) CYPS will continue to offer services to young people in Northumberland Albion Road and Balliol Monday-Friday 8.30am-5pm CAMHS: no change to existing referral pathways CAMHS: Balliol Centre, Longbenton Albion Road Clinic, North Shields

13 Northumbria Specialist Emergency Care Hospital Elderly (Elderly Assessment, Frail Elderly, Ambulatory) Acutely ill older person who clearly needs admission Refer to the for admission via the emergency department Northumbria Specialist Emergency Care Hospital Referrals to the Refer to the Northumbria hospital through the GP hotline If you feel the patient is not acutely unwell but still needs timely assessment, consider discussion with the Elderly Assessment Centre (see opposite)

14 Existing hospitals Elderly (Elderly Assessment, Frail Elderly, Ambulatory) continued Complex older person who needs urgent (same or next day) multi-disciplinary assessment Refer to an elderly assessment centre at North Tyneside or general hospitals. We will be opening a centre at Hexham in July. These centres allow multi-disciplinary assessment and/or diagnostic tests to take place without admission to hospital Not suitable for physiologically unstable patients Older person who would benefit from comprehensive geriatric assessment (CGA) within the week or require rehabilitation Refer to the Jubilee Day Hospital at The Jubilee Day Hospital provides multi-disciplinary assessment for complex elderly patients with access to diagnostic tests Elderly assessment centres: Hexham Jubilee Day Hospital at Tuesday, Wednesday, Thursday, three appointment slots at 10am (from July) Monday-Friday 9am-5pm (last appointment time 3pm) Monday-Friday 9am-5pm (last appointment time 3pm) Monday-Friday 8.30am-4pm No change to existing referral pathways Patients may still be directed to the after discussions Hexham /7 (from July) geriatrics.wansbeck@ northumbria.nhs.uk Or contact all three elderly assessment centres through the GP hotline Refer to Jubilee Day Hospital at General Hospital Call extension 2953 Monday-Friday 8.30am-4pm Or call the GP hotline Elderly (Elderly Assessment, Frail Elderly, Ambulatory)

15 Northumbria Specialist Emergency Care Hospital Gastroenterology Acute admissions All acute emergencies will go to the emergency department at the Northumbria Specialist Emergency Care Hospital All acute emergencies to the Refer to the Northumbria hospital through the GP hotline Gastroenterology consultant available for advice 9am-5pm via GI advice line Outside of these times please call the GP hotline

16 Existing hospitals Gastroenterology continued Elective admissions Elective ERCP patients will be admitted to the acute GI ward at the Northumbria hospital Elective admissions for alcohol detoxification will be admitted to the GI ward at North Tyneside Elective admissions for bowel prep prior colonoscopy and also liver biopsies will be either admitted to the GI ward at North Tyneside or the surgical base ward at. Elective admission for colonoscopy will also be possible at Hexham Outpatients For, and Hexham general hospitals no change to existing referral pathways Hexham Hexham There will no longer be a dedicated GI ward at General Hospital No change to current referral pathway Referral letter or fax: / Hexham Gastroenterology consultant available for advice 9am-5pm via the GI advice line Or call the GP hotline Referral letter, Choose and Book or fax to numbers as given above Gastroenterology consultant available for advice 9am-5pm via the GI advice line Or call the GP hotline Gastroenterology Elective endoscopy For, and Hexham general hospitals no change to existing referral pathways Hexham No change to current referral pathway Referral form, letter or fax: / Hexham Gastroenterology consultant available for advice 9am-5pm via the GI advice line Or call the GP hotline

17 Northumbria Specialist Emergency Care Hospital General Surgery Adults (>16) with acute surgical conditions should be referred directly to the Surgical Assessment Unit (SAU) at the Allows you to refer patients directly to the surgical team, bypassing the emergency department (for stable patients) A consultant-led team is on hand to treat emergency surgical patients for acute conditions such as abdominal pain, cholecystitis, renal colic and appendicitis SAU at Northumbria Specialist Emergency Care Hospital 7 days a week 7.30am-8.30pm Last referral 7.30pm After these times please refer through the emergency department SAU now based at the Extended hours with potential to extend further according to demand Referrals direct to SAU, call , or through the GP hotline Adults (>16) with acute surgical conditions (as above) not fulfilling the current admission guidelines for SAU (as above) should be admitted via emergency department Surgical review in the emergency department will be undertaken to determine if admission is required Emergency department, Northumbria Specialist Emergency Care Hospital No change to referral process, but patients should be sent to the Northumbria hospital Referral letter as per current practice and refer to the through the GP hotline If you need urgent advice about an adult s diagnosis or treatment you can speak to the consultant surgeon on duty at the If as a result of this referral an urgent outpatient department review or investigation is required, this will either be arranged by the consultant surgeon or the appropriate referral pathway recommended Northumbria Specialist Emergency Care Hospital 8am-8pm After 8pm surgical registrar on-call available Easier access to telephone advice from consultant surgeons Please call the GP hotline on

18 Existing hospitals General Surgery continued Nurse specialist advice for patients currently under follow up Eg. Cancer patients Hexham 9am-5pm Monday-Friday, if unavailable an answerphone message can be left No change Nurse specialists: Upper GI - Trustwide (cancer): (benign): (benign): Breast - : or : Routine blood and radiology investigations will continue to be carried out at North Tyneside and general hospitals 9am-5pm Monday-Friday No change Colorectal - (cancer): (stoma nurse): : Or call the GP hotline Request in usual manner, or call the GP hotline General Surgery Adults already under current care of specialist surgical services at either Freeman Hospital or RVI should be referred to appropriate team Via Newcastle Hospitals switchboard

19 Northumbria Specialist Emergency Care Hospital Gynaecology Emergency gynaecology assessment Any patient GPs have significant concerns about should be referred directly to the Alternatively patients can still be referred into the emergency gynaecology clinics at our general hospitals (see opposite) Surgical Assessment Unit (SAU) at Northumbria Specialist Emergency Care Hospital Specialist nurses are available 9am-5pm, Monday-Friday and 9am-1pm, Saturday and Sunday Additional to all current gynaecology services Through SAU at the at the given times or through the GP hotline Outside of these times patients should be referred through the emergency department

20 Existing hospitals Gynaecology continued Emergency gynaecology clinic Patients with early pregnancy problems (up to 12 weeks gestation) such as pain or significant bleeding Hexham 9am-11am 9am-12noon 9am-12noon Additional to existing service, only change is General Hospital, emergency gynaecology clinic will now be open 9am-12.30pm instead of 9am-5pm Hexham All other clinics at our existing hospitals remain the same Gynaecology

21 Northumbria Specialist Emergency Care Hospital Maternity Consultant obstetric high risk pregnancy birthing service, full obstetric service, 24 hour epidural and theatre facilities for high-risk pregnancy. Ante-natal and post-natal ward in patient single en-suite rooms The Birthing Centre Northumbria Specialist Emergency Care Hospital Moving from Refer to community midwife, or call the GP hotline Midwifery-led low-risk birthing service, all women with low-risk pregnancy can book for delivery in this new co-located midwifery-led birthing unit The Birthing Centre Northumbria Specialist Emergency Care Hospital Moving from and North Tyneside 's midwifery-led unit to the Refer to community midwife, or call the GP hotline

22 Existing hospitals Maternity continued Midwifery-led low-risk birthing service Alnwick Infirmary Berwick Infirmary Monday-Friday, 8am-6pm Saturday and Sunday 8am-2.30pm Out of hours: on-call for deliveries None Call service directly through the GP hotline Hexham Pregnancy Assessment Unit (PAU) - for pregnancies over 12 weeks High-risk ante-natal care clinics (ANC) PAU and ANC at: Monday-Friday 8.30am-6pm Monday-Friday 8.30am-6pm None Call PAU/clinic directly through the GP hotline Maternity Consultant-led ante-natal clinic None Call clinic directly through the GP hotline Community, consultant-led, high-risk ante-natal clinics Alnwick Berwick Blyth Cramlington Set clinic days None Call clinic directly through the GP hotline

23 Northumbria Specialist Emergency Care Hospital Palliative Care Specialist nurse advice 8.30am-5pm South East Northumberland 8.30am-5pm West Northumberland 8.30am-5pm North Northumberland 8.30am-5pm Consultant advice 9am-5pm Call the GP hotline or call Northumberland 9am-5pm Call the GP hotline or call Telephone advice out of hours North of Tyne 5pm-8.30pm

24 Existing hospitals Palliative Care continued Admissons to Palliative Care Unit (PCU) Palliative Care Unit North Tyneside Palliative Care Unit Direct admissions 9am-5pm. Out of hours admissions via Northumbria Specialist Emergency Care Hospital Telephone or fax Telephone or fax Or call the GP hotline Consultant direct referrals/advice Outpatient clinics Northumberland 9am-5pm 9am-5pm Or call the GP hotline Via Choose and Book or telephone or fax Palliative Care / Morpeth NHS Centre/ Blyth Community Hospital Via Choose and Book or telephone or fax Advice or request for home/community hospital assessment South East Northumberland Community Palliative Care team: South East Northumberland Palliative Care team: West Northumberland West Northumberland Palliative Care team: North Northumberland North Northumberland Palliative Care team:

25 Northumbria Specialist Emergency Care Hospital Respiratory Acute respiratory admissions All acute emergencies to go to the emergency department at the Northumbria Specialist Emergency Care Hospital No change to current referral pathways, but if a patient needs to be admitted this will now be to the Refer to the Northumbria hospital through the GP hotline if you have any concerns about a patient Urgent advice For urgent advice on a known patient, contact the relevant consultant first via the GP hotline on If the relevant consultant is unavailable, or if a new patient, and this is for urgent advice to alter acute management, contact the respiratory consultant on-call at the Trustwide 8am-8pm After 8pm call the specialist registrar at the Northumbria hospital Existing patient Contact the relevant consultant, or if unavailable, the consultant on-call at the on the GP hotline New patients Call the respiratory consultant on-call at the on the GP hotline

26 Existing hospitals Respiratory continued Outpatients Trustwide As current No change to current outpatient sites or services, or existing referral pathways Same as currently, or call the GP hotline Respiratory

27 Northumbria Specialist Emergency Care Hospital Rheumatology Acutely unwell rheumatology patient on DMARDs or biologic drugs Northumbria Specialist Emergency Care Hospital Referrals to the Refer via GP hotline Rheumatologist of the day available to discuss 9am-5pm Suspected cases of giant cell arteritis (without visual loss only - cases with visual losses should be referred to RVI opthalmology) Northumbria Specialist Emergency Care Hospital Referrals to the Discuss with rheumatologist of the day via GP hotline to arrange TA Bx and urgent OPD review Refer via GP hotline for assessment/to arrange TA Bx Acute hot joints Northumbria Specialist Emergency Care Hospital Referrals to the Refer via GP hotline

28 Existing hospitals Rheumatology continued Early arthritis outpatient referrals Aim to see within 3 weeks, Morpeth NHS Centre (soon to expand to other sites) As current No change to existing referral pathways No change to existing referral pathways Refer via Choose and Book or fax referrals to (North Tyneside, Hexham ) or (, Blyth Community Hospital, Morpeth NHS Centre, AInwick Infirmary, Berwick NHS Centre) Or call GP hotline Adolescent rheumatology outpatient referrals for year olds, Morpeth NHS Centre As current No change to existing referral pathways Refer via Choose and Book or fax referrals to ( ) or (Morpeth NHS Centre) Or call GP hotline Rheumatology General rheumatology outpatients Hexham Blyth Community Hospital As current No change to existing referral pathways Refer via Choose and Book or fax referrals to (North Tyneside, Hexham ) or (, Blyth Community Hospital, Morpeth, AInwick Infirmary, Berwick Infirmary) GB Hunter Morpeth NHS Centre Or call GP hotline Alnwick Infirmary Berwick Infirmary

29 Northumbria Specialist Emergency Care Hospital Stroke Hyperacute stroke care Adults with acute stroke or possible stroke diagnosis should be sent immediately to the emergency department at the Northumbria Specialist Emergency Care Hospital via emergency ambulance Northumbria Specialist Emergency Care Hospital, with specialist stroke consultant cover throughout All patients with acute stroke should be directed to the, for hyperacute care Emergency ambulance referral for this group no advance referral required. If advice required contact the on-call stroke nurse practitioner at the (8am-8pm) or the on-call stroke consultant (8pm-8am) through the GP hotline Transient Ischaemic Attack (TIA): High or undetermined risk Adults with possible high risk (TIA) should be immediately referred to the stroke nurse practitioner for specialist assessment through ambulatory care if appropriate ABCD2 score of >3, or More than one episode, or Associated atrial fibrillation or TIA where these high risk factors cannot be immediately excluded Medical ambulatory care at Northumbria Specialist Emergency Care Hospital 7 days, 8am-8pm All patients with possible high risk TIA will be assessed at the Refer to the on-call stroke nurse practitioner via the GP hotline For out-of-hours advice contact the on-call stroke consultant at the through the GP hotline Transient Ischaemic Attack (TIA): Low risk Adults with possible diagnosis of low risk TIA (and only when higher risk can be confidently excluded) should be referred by fax to the Faxed referrals will be assessed at the and appointments will be sent to attend clinics at Hexham, and general hospitals See under Fax referral to the For advice contact the stroke nurse practitioner (8am-8pm) on the GP hotline

30 Existing hospitals Stroke continued Acute stroke units Adults with a diagnosis of stroke who are current inpatients in other hospitals, but are residents of North Tyneside or Northumberland, and need further inpatient care can be referred for ongoing inpatient care on the acute stroke units at, and Hexham general hospitals. Referrals accepted from hospitals providing acute care for current inpatients who live in or Northumberland Hexham Referrals reviewed 5 days a week 9am-4pm No change to the existing care pathway Please fax a referral to: (Dr Curless Secretary) General (Dr Huntley's secretary) Hexham General (stroke secretary) Or call the GP hotline Stroke Early supported discharge teams Adults with a diagnosis of stroke who are current inpatients in other hospitals, but are residents of or Northumberland, and need ongoing rehabilitation on discharge can be referred and south-east Northumberland areas Referrals reviewed 5 days a week 9am-4pm Service delivered 7 days a week 8am-9pm No change to the existing care pathway Please fax a referral to the team: Tel: Fax: Tel: Fax: Or call the GP hotline The stroke information service Provides information, advice and support for people wanting to learn about stroke and the support available in the hospital and community Calls received 5 days a week 9am-5pm No change to the existing care pathway Tel/fax: E: strokeinfo@nhct.nhs.uk Mobile Or call the GP hotline

31 Northumbria Specialist Emergency Care Hospital Trauma and Orthopaedics Emergency orthopaedic injuries: long bone fractures, hip fractures, open fractures, septic arthritis Northumbria Specialist Emergency Care Hospital Admission to the Refer to the Northumbria hospital or for advice call the GP hotline

32 Existing hospitals Trauma and Orthopaedics continued Minor orthopaedic injuries: wrist fractures, ankle fractures, clavicle fractures 24 hour walk-in services: As current Self-presentation, or call the GP hotline Urgent orthopaedic advice on how to manage urgent problems Non-urgent orthopaedic conditions requiring advice Elective orthopaedic referrals Hexham General Hospital Trustwide Trustwide Trustwide Office hours Office hours As current As current As current Ask for orthopaedic specialist registrar on-call through the GP hotline Call the GP hotline Choose & Book, faxed referral, named referral through contact centre, or call the GP hotline Trauma and Orthopaedics Post-operative problems Office hours As current Surgical helpline or call the GP hotline Out of hours As current Orthopaedic specialist registrar through the GP hotline

33 GP hotline: For non-clinical general enquiries, Website: gp.northumbria.nhs.uk