Advice & Guidance Service

Service Overview

The cardiologists at UHBW and NBT both offer Cardiology Advice and Guidance via eReferral. These services should be utilised where advice is required on the management of a patient that may avoid the need for referral. It should not be used where immediate advice is required, in which case the on call teams should be contacted in the usual way.

All requests should be submitted directly to the Cardiology Advice & Guidance Service at either UHBW or NBT using e-Referral.

Please note that UHBW Bristol will give advice on patients 16 years and over, whilst NBT and UHBW Weston only provide advice for those over 18 years old.

The trusts are committed to utilising eReferral for this purpose. Please be aware, that there is a risk the trust may return your request if you do not follow the preferred pathway.

To enable the consultants to give the best advice possible please consider the following points:

• Give a clear concise history and examination findings- avoid cutting and pasting long lists of consultation notes that are not relevant to the problem in hand.
• Include relevant results, investigations and recent correspondence if appropriate but avoid multiple attachments that can take time to download and make the triage process more cumbersome.
• Ask a clear clinical question and avoid ambiguity.
• Avoid requests for complex patients known to an individual consultant as they are unlikely to be the consultant giving the advice and may not have easy access to details of previous contacts with the patient. In these cases consider writing or emailing the relevant secretary directly. 

Please note: Referrals to cardiology outpatients via eRS may be clinically triaged by the BNSSG CCG Referral Service. If considered appropriate for advice and guidance by one of the GP triagers, these referrals may be returned to the referrer to consider this option. 

UHBW Cardiology Advice & Guidance

The UHBW Cardiology A&G service provides advice for GPs on management of cardiology problems for adult patients (age 16 and over). See above for guidelines on appropriate use of this service. A cardiologist will aim to reply within 7 days.

Please see the Cardiology A&G Steps - UHB (Bristol) or Cardiology A&G Steps - WGH for instructions on how to complete a request through eRS.

Please process through e-Referral bypassing the Referral Service.  Advice requests should ideally be typed into the free text window of the advice request body on e-RS rather than attaching a separate letter or Word document. If you attach a Clinical Information Summary, please ensure it is named this, so that clinicians at secondary care can opt to look at it if they wish to turn the request into a referral.

• Cardiology Advice Only - University Hospitals Bristol - RA7

Priority - Routine
Specialty - Cardiology
Clinic - Not Otherwise Specified

• Cardiology Heart Failure Advice - University Hospitals Bristol - RA7

Priority - Routine
Specialty - Cardiology
Clinic - Heart Failure

• Advice & Guidance - General Cardiology - Weston Area Health Trust - RA3 (Age 18 and over)

Priority - Routine 
Specialty - Cardiology
Clinic - Not Otherwise Specified

NBT Cardiology Advice & Guidance

The NBT Cardiology A&G service provides advice for GPs on management of cardiology problems (including heart failure) for adult patients (age 18 and over). See above for general guidelines on appropriate use of this service and exclusion criteria below. A cardiologist will aim to reply within 7 days.

Exclusion criteria:

• Urgent requests for advice
• Requests for a second opinion
• Requests to escalate an existing referral
• Requests for advice on patients already under the care of Cardiology in Bristol

Please see the Cardiology A&G Steps - Southmead (word doc) for instructions on how to complete a request through eRS.

Please process through e-Referral bypassing the Referral Service. Advice requests should ideally be typed into the free text window of the advice request body on e-RS rather than attaching a separate letter or Word document. If you attach a Clinical Information Summary, please ensure it is named this, so that clinicians at secondary care can opt to look at it if they wish to turn the request into a referral.

• NBT Cardiology A&G via eRS

Priority - Routine only
Specialty - Cardiology
Clinic - Not Otherwise Specified

Please contact cardiology secretaries at NBT for patients already under the care of a NBT Cardiologist or regarding an existing referral.

Cardiology Secretaries can be contacted by email CardiologySecretaries@nbt.nhs.uk ot phone: 0117 414 0199 

Community Heart Failure A&G

Sirona Community Heart Failure Service provide telephone advice. Please see the Heart Failure page for more details

Response times

The waiting time tool for BNSSG GP practices includes a section on A and G waiting times. You will need to download the document and follow the instructions to access the latest information (updated monthly). Please see the Hospital waiting times page.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.