Advice & Guidance Service

Service Overview

Gynaecology advice and guidance via eRS can be requested for patients aged 16 and over. (This includes advice and guidance for the menopause). Paper letters requesting advice should be avoided and may lead to a delay in response.

The BNSSG Referral Service may return referrals to gynae outpatient clinics and advise GPs to use an A and G service when appropriate.

Please note that these A and G services should not be used for:

• Obstetric/antenatal concerns - please see the Maternity Services page
• Colposcopy requests or results - please see the Cervical conditions page
• Requests for an outpatient appointment - use eRS
• Children aged 15 or under (please see the Child and Adolescent Gynae page)
• Reproductive medicine - see the Fertility (Remedy BNSSG ICB) section.

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.
• If requesting advice on patients previously under the care of gynaecology, please direct these to the trust at which they have been seen or state clearly why advice if being sought from a different trust.

Please include patient BMI, past medical history and medication history for all gynae A and G requests.

Menopause - Review the Menopause section prior to requesting A and G to see if your query is answered in this section.  To allow the gynaecologists to provide targeted advice, it is especially important to provide PMH, BMI and medication history, including doses of oestradiol and progestogen.

Vulval Conditions - If asking for advice on vulval conditions, please include examination findings. You may also find helpful advice on the Vulval Skin Conditions page.

Exclusions

• Male infertility - see the Fertility (Remedy BNSSG ICB) section.
• Advice about testosterone use in the menopause - see the Menopause section. 

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.

UHBW Gynaecology Advice & Guidance

Please see the attached for information the UHBW Gynaecology team will provide advice on.

This service 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.

Please process through eRS 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.

• Service ID: 7961825 - Gynaecology Advice – StMH & Weston - UHBW – RA7

Priority - Routine
Specialty - Gynaecology
Clinic - Not Otherwise Specified

NBT Gynaecology Advice & Guidance

This service 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.

Please process through eRS 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.

• General Gynaecology - Advice & Guidance - Southmead RVJ

Priority - Routine
Specialty - Gynaecology
Clinic - Not Otherwise Specified

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.