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Neurosurgical Pathologies - management and onward referral DRAFT

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Overview

All the information on this page has been produced in partnership with James Pendle, Olivier Sluijters and Adam Williams at NBT.

The neurosurgical department at NBT is a tertiary referral unit and therefore does not usually accept referrals directly from GPs. However, there is access to certain neurosurgery clinics via eReferral and these are described in the directory of services of eRS. Please note that many of these clinics are Referral Assessment Services (RAS) so referrals may be returned to referrer if not appropriate.

Patients with suspected cranial or spinal trauma should usually be referred to the local Accident and Emergency Department for imaging prior to onward referral if necessary.

Patients with suspected cancer should be referred via the Brain and CNS – USC (2WW) pathway.

Post Operative Concerns - If you have acute concerns about a patient who has recently had a neurosurgical procedure and you require a same-day response, please refer urgently to our on-call via Refer-a-Patient.

If you do not require same day advice, please contact the patient’s surgical team. These details should be available on their recent clinic / discharge letters.

Patients for other neurosurgical procedures will normally be referred from other secondary care specialties or MSK Interface Service.

Referral

The referral pathways for neurosurgical services are broadly split into 3.

Referapatient - this is the on-call team and is monitored 24/7 by the on-call registrar. If you are referring an emergency that requires our immediate attention, please also call the on-call phone (0117 414 5726).
ERS - these referrals are triaged by our secretaries / advanced nurse practitioners and directed to the appropriate consultant team.
MDTs - there are several subspecialty MDTs that meet on a weekly or monthly basis, where complex and/or semi-urgent cases can be discussed.

Please visit the Neurosurgery Remedy pages within the for the relevant condition for information and guidance on pathways.

Resources

Links to NBT Services

Neurosurgery

Bristol Neuro-oncology Group

Neurosurgery MDT Referral to Multidisciplinary Team Meetings (MDT) at North Bristol Trust

Neuro-oncology (BNOG) Referrals

Head Injury Therapy Unit (HITU) On-call referrals: https://www.referapatient.org/refer-a-patient

ERS referrals: LINK?

GIRFT guidance: Spinal – Suspected Cauda Equina Syndrome 2a - GIRFT - Pathways

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.