New guidelines for referrals from lower GI services

The gastrointestinal service has changed its guidelines for referrals to the lower GI two-week wait (2WW) pathway as well as its process for new referrals.

A FIT test should be completed in primary care before all referrals.

Referrals received with symptoms of IDA, mass, anal ulceration and marked weight loss (10%)

• FIT test will be used for stratifying diagnostics.
• If FIT test results are not provided or not available then clinician will still proceed to investigations.

Referrals received without symptoms of IDA, mass, anal ulceration or marked weight loss (10%) and no FIT test

• Please indicate clearly on the referral form why a FIT test has not been carried out. We will use this to assist in decision-making about next steps.

Referrals received without symptoms of IDA, mass, anal ulceration or marked weight loss (10%) and FIT test over 10

• Referral will be accepted and patient booked into a telephone clinic.

Referrals received without symptoms of IDA, mass, anal ulceration or marked weight loss (10%) and FIT test under 10

• Referral will be accepted and a safety net appointment will be made.

If you are worried about a patient that does not fit the above criteria, or you wish to discuss other concerns, we have turned on our advice and guidance service on e-referrals. We aim to respond to your query within two working days.

Contact: Tally Lazarus, general manager, GI services, tally.lazarus@nhs.net