Inpatient referrals

1. On the NHS Lothian Intranet home page, search for “PARU”
2. Click on the webpage link “PARU-RHCYP”
3. From the green menu bars, select “How to…”
4. The top section is entitled “How to refer..”. Find the paediatric specialty you require and click on the link. This will load a PDF document with instructions on how to refer for inpatient review and/or outpatient appointments. This information is kept up to date by the PARU team.

 

Outpatient Referrals

As of 22/3/21 the specialty teams at RHCYP are moving over to an electronic Trak referral system.

Please see the list of specialty codes below for use within Trak letters. These will generate ‘canned text’ and include instructions relevant to that specialty only. It is important that one follows the instructions exactly, so that details will be picked up by the correct team in a timely manner.

 

To use a ‘paeds backslash’ code in Maternity Trak:

1. Open the correct episode for the baby you would like to refer (M/W – Well Baby or Neonatal Paediatrics).
2. Select ‘Discharge Letter / Meds’.
3. Next to the blue hyperlink ‘Correspondence’, select +New.
4. A letter template will appear. The note type will either be an Outpatient Clinic Letter or an Inpatient Discharge Summary (either is fine).
5. In the letter box, type in the specialty code you require (taking care to use a backslash and not a forward slash) followed by a space.
6. Complete the letter proforma and follow the specialty specific instructions on who to send the referral to by email as this is different for each team.
7. Change the Status from ‘Entered’ to ‘Authorised’, enter your password and press UPDATE

• Audiology - \paedsaudiology
• Cardiology - \paedscardio
• Dermatology - \paedsderm
• Endocrinology - \paedsneoendoc
• ENT - \paedsent
• General surgery - \paedssurgery
• Genetics - \paedsgeneticsOP (for acute IP referrals \paedsgeneticsIP)
• GI - \paedsGI
• Haematology - \paedshaem
• Infectious diseases - \paedsID
• Neurology - \paedsneurology
• Neurosurgery - \paedsneurosurg
• Ophthalmology - \paedsophthalmology
• Orthopaedics - \paedsortho
• Physiotherapy - \paedsphysio
• Plastics - \paedsplastics
• Renal - \paedsrenalnnu
• Respiratory - \paedsresp
• Rheumatology - \paedsrheum
• Spinal - \paedsspinal
• Urology - \paedsurology

 

If you can’t remember the exact wording of the specialty code you need, type “\paeds” in the letter box and press F6 - the list of current backslashes will appear (please note, this is a much fuller list which includes some referrals for investigations).

Other useful information for referrers

Cardiology – Neonatologist Murmur clinic

Arranging follow-up in murmur clinic: (Currently under COVID restrictions, murmur clinic is not running on NICU – contact the postnatal ward consultant on bleep 4133 for advice regarding possible ECHO prior to discharge)

• Refer to the murmur clinic guideline/ flowchart for specific follow-up advice
• Arrange follow-up in the Wednesday murmur clinic (time interval as per flowchart)
• Type a brief TRAK correspondence with details of your assessment and follow-up
• Send a printed copy of the correspondence letter to the GP for their information
• Provide parents with a “heart murmur” parent information leaflet (found in reference library on Badger under parent information leaflets), a printed copy of the TRAK correspondence letter and note of the date and time of their clinic appointment

Microbiology

Obtaining advice: 26066 – On-call microbiologist

Calling microbiology lab for microscopy: 26021

Cytogenetics

For urgent result: Call 0131 537 2998 to speak to post-natal cytogenetics prior to taking and sending sample

Sending a sample: Send samples below with genetics consent form. If immediate transport not available, place in sample fridge on NNU (in the same room as the gas machine). It is advisable to call the labs to make them aware that a sample should soon be with them 01315271940.

 

Sample type	Volume of whole blood for either LiHep (orange) or EDTA (pink)
Adult or Child	2ml
Newborn	1ml
Cord blood	0.5ml

Physio – Neonatal

DDH (see guideline)

All secondary screening (inpatient and outpatient) is done by clinical screening from physiotherapists.

• On 119 and 211 write patient referral details in the hip section of the baby workbook
• On labour ward or LBC please radiopage via switchboard
  • Sarah Paterson 07623972923
  • Lauren Fraser 07623973884
  • Caoilfhionn Deeney 07623973884
• On NNU make a referral once baby is nursed in an open cot, by writing the patient details in the yellow folder in Calton Nursery. Physios visit the unit routinely weekly.

If referral is needed but baby is discharged the physio team will automatically pick up and arrange review if the “hip dysplasia risk” section of the routine examination of the newborn has been completed. Routine referrals are seen within 8 weeks so please indicate this to the parents when you inform them of the need for referral. If the hip is unstable, please state this on the newborn examination form and the baby will be seen urgently.

Erb’s palsy (see guideline)

• Type a TRAK correspondence letter. Send a copy of this as an e-mail to the Erb’s Palsy Physiotherapy service at RHCYP prior to discharge: email Mairi.McCrae@nhslothian.scot.nhs.uk
• Provide parents with a copy of the letter and an Erb’s palsy parent information leaflet (available on Badger reference library under parent info leaflets)

Facial Palsy

• Type a TRAK correspondence letter. Send a copy of this as an e-mail to the Facial Palsy Physiotherapy service at RHCYP prior to discharge: email Valerie@nhslothian.scot.nhs.uk

Plastics - Outpatients

Write a TRAK correspondence letter. Send copy to the appropriate consultant/s as below:

• Hands and feet Lam@nhslothian.scot.nhs.uk
• Ears Stewart@nhslothian.scot.nhs.uk
• Vascular/lumps Addison@nhslothian.scot.nhs.uk + William.Anderson@nhslothian.scot.nhs.uk

Radiology

X-rays and some ultrasound scans are ordered through RIE radiology to occur in The Simpson. All specialist scans (e.g. contrast, CT and MRI) are ordered through the radiology department at the RHCYP. If in doubt, discuss the case with the radiologist on duty.

Scans are requested via TRAK. Ensure the order location is updated and correct as this will default to the RIE. Click on the Requested scan and update the receiving location (see below).

 

Virology

Clinical advice during working hours: 63373

Urgent clinical advice OOH: On-call virologist via switchboard

Non-urgent advice: VirologyAdvice@nhslothian.scot.nhs.uk

Virology labs: 26086