Advice & Guidance - Neurology/HOT Clinic

Overview

The neurologists at NBT are now offering several routes to access advice and urgent appointments including telephone advice and Advice and Guidance via e-RS. Patients must be 16 years and over.

GPs can now also access the neurology HOT clinic  (see further details below).

Please note:

Neurology – provides outpatient and inpatient services for adults with neurological problems; including: Epilepsy, First Seizure, Parkinson’s Disease, Multiple Sclerosis, Neuromuscular Disorders and Movement Disorders.

Neurosurgery - please see the neurosurgery page for details on how to refer or get advice on a range of neurosurgical problems

NBT Neurology Advice & Guidance

NBT now offer a Neurology Advice & Guidance Service to all BNSSG practices available via e-RS. Advice and guidance requests will be checked daily (Monday to Friday) and the Neurology Team will endeavour to reply to requests for advice within 24 hours.

GPs can no longer access the neurology HOT clinic via this route (but please see further details in HOT Clinic section below).

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.
• Include patient contact details including up to date telephone number. Also include contact details for the referrer including a direct contact or mobile telephone number if possible.

Exclusions:

• not to be used for ongoing management of a patient under a Neurology Specialist in Bristol
• not for TIA/Stroke referrals
• not for 1st fit referrals/discussions - see First Seizure Clinic page
• not for second opinion

Please see the relevant information below on how to make an advice request via e-Referral to NBT:

NBT - Neurology A&G Guidance document

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.

• General Neurology Advice and Guidance - Southmead - RVJ

Priority - Routine
Specialty - Neurology
Clinic - Not Otherwise Specified

Neurology Secretaries - email NBTNeurologySecretaries@nbt.nhs.uk 

Email responses will be returned within 7 calendar days.

If a response has not been received within 7 calendar days please escalate this via Outpatients.Appointments@nbt.nhs.uk

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.

• Neuropsychiatry – On call Consultant via NBT switchboard or 0117 414 0483 or Rosa Burden Team 0117 414 0451.

Telephone advice

NBT also provide a Neurology Telephone Advice Line for GPs.

GPs Telephone advice line: 0117 414 1917  (This number is for professionals only and strictly not for patient use)

• 9am to 5pm.
• This will be a direct dial to a consultant.
• There will be no voicemail for messages.
• The only use for this phone is for GP advice.
• If the line is engaged we are speaking to another GP, please call back.
• After 5pm calls will revert to the on call registrar bleep

HOT Clinic

HOT clinic appointments may be offered as a result of a telephone conversation with a neurologist.

To refer to Hot clinic, GPs can either:

• Call 0117 414 1917  (9am to 5pm) to speak to consultant of the day (This number is for professionals only and strictly not for patient use)
• Call NBT switchboard and ask to speak to neurology registrar on call (who will be contacted via bleep).

Once a Hot clinic referral has been accepted please email a referral letter to:

• NBTneurologySecretaries@nbt.nhs.uk

(Please mark your email high priority and add 'HOT CLINIC REFERRAL' in the subject bar).

The HOT clinic is not routinely available on Sat or Sun, as the neurology team then moves to cover TIAs.  Most patients referred on a Friday will go to the Monday HOT clinic, although acutely unwell patients can of course be seen more urgently.

Huntington's Disease A&G

Please see the Huntington's Disease 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.