Publish date: 07 October 2022

A single point of access pilot for all hernia surgery referrals to the Whittington and UCLH will commence on Monday 10 October 2022.

Patients will be directed to a NCL Referral Assessment Service (RAS) for hernias called "General Surgery Hernias (RAS) – NCL Hub".

Referrals will be triaged within five working days by a hernia specialist surgeon and then directed to either UCLH for more complex surgery or the Whittington for lower complexity surgery.   

There will be no change to the process for emergency referrals.

To streamline the process for both primary care and secondary care clinicians, a bespoke auto-populating NCL hernia referral form, which extracts key clinical and other information, has been embedded into EMIS. Completing this form with the required information will ensure patients are appropriately triaged and quickly directed to the correct clinical team.

To find the form, please go to:
For Barnet practices: BAR Global Documents folder > Referral Forms folder > North Central London Hub Hernia Referral form

For Camden practices: Camden practices can access the form (called 'North Central London Hub Hernia Referral form') from EMIS
NB. Camden practices which do not have an activated 'Resource Publisher sharing agreement' with NCL ICB will need to download this form from the 'EMIS Forms' page of the NCL ICB GP website (see 'All other forms' section).

For Enfield practices: ENF Global Documents folder > Hernia folder > North Central London Hub Hernia Referral form

For Haringey practices: HAR Global Documents folder > Hernia folder > North Central London Hub Hernia Referral form

For Islington practices: ISL Global Documents folder > Hernia folder > North Central London Hub Hernia Referral form

From Monday 10 October, for any routine hernia referrals to UCLH or Whittington:

  • Camden, Haringey and Islington GPs should send referrals to CHI RSS as usual but attach the EMIS hernia referral form. 
  • Barnet and Enfield GPs specifically referring to UCLH/Whittington should follow the usual referral process but also attach the EMIS referral form.

All urgent (but not emergency) referrals should be marked as "urgent" and either referred directly via eRS for Camden, Haringey and Islington, or in the usual way for Barnet and Enfield patients. Please note that in the new NCL pathway, groin hernia or suspected groin hernia in women requires an urgent referral.

When referring, GPs should advise their patients that they will be contacted and given an appointment by the trust that is the most clinically appropriate for their surgery. Patients should also have agreed that they wish to explore a surgical option.

A hernia pathway has been developed with GP input to support primary care teams in decision-making, and is available on the NCL GP website.

There will be a process of ongoing evaluation and if the process for clinical triage and referral diversion is successful, the pilot will be rapidly rolled out to all NCL trusts providing a surgical hernia service. The pilot will continue until the end of March 2023.