Guide to virtual fast track TIA clinics for trainees

In QEUH stroke our fast track TIA clinics are currently virtual.  These are mainly telephone assessments although we are looking at trying to incorporate attend anywhere more in the future. 

There should be a TIA clinic every weekday.  These clinics may also see a mixture of non-fast track referrals and return patients.

Current Stroke clinic timetable

Monday – am Dr Hughes, virtual clinic

Monday – pm Prof Walters, virtual clinic

Tuesday – am Dr Sitaram / Dr Huang, INS outpatients

Wednesday – am Dr Sitaram, Langlands day hospital

Wednesday am Dr Colin Muir, virtual clinic

Thursday – pm Dr Sitaram, INS outpatients

Friday – am Dr Shah, virtual clinic

Friday – am Prof Dawson, virtual clinic

TIA clinic lends itself well to the virtual format as history taking is key.  It is a great opportunity for mini-cex / CBD.  Even if you are in GGH or part of a busy team, it may be feasible to assess even one new patient if you are able to take 30 minutes or so off the ward. 

Where

During the pandemic most virtual clinics have been done in office space.  We are trying to move towards all virtual clinics being done in a clinic space so the location of these clinics may change.  If you are doing a virtual clinic then you could check with Langlands day hospital to see if there is a free room for you to assess your patient (e.g. Friday where there are no other clinics) or alternatively one of the Langlands SPR offices is usually free.  Assessing the patient in a ward office is an option too but less suitable if you are going to be interrupted.   

If you are allocated a fast track TIA clinic slot, we would ask that you contact the consultant the day before to confirm you will be attending.  Then touch base with them first thing on the day of the clinic, to agree which referrals you are going to phone.  They may even allocate the day before if the patients are already booked in.  You can then arrange a time to discuss the referral after you have phoned the patient, and agree on a management plan. 

Outcomes

If, following discussion with the consultant, you feel that a patient requires admission then this can be discussed with the on-call stroke SPR (83234).

It may be that the patient requires a face to face assessment, the stroke consultant will be able to advise on how to arrange this, likely in discussion with the Langlands day hospital team or via one of clinics which have allocated clinic rooms. 

There are Fast track imaging slots available. Maureen Nolan (Maureen.Nolan@ggc.scot.nhs.uk) in Langlands can be contacted to arrange CT, CTA , ECG and Bloods via the Neurology outpatient slots (there are now 3 slots for this every weekday.)  She may ask you to electronically sign a form to authorise these tests. 

or alternatively contact Marie.MacIver@ggc.scot.nhs.uk based in Langlands. 

Other bloods can be requested via the phlebotomy hub

If you wish a carotid doppler, Karen Shields can arrange this as an outpatient.  Request the doppler on Trak FAO Karen Shields in 1C, then email her (Karen.Shields2@ggc.scot.nhs.uk) to let her know of the request.

If you are in GGH, Irene the secretary on level 3 offices will provide you with a dictaphone. 

If you are in Langlands you may be able to access a dictaphone via day hospital or potentially from the the registrar offices (1C or langlands.)  There is also a spare one in Dr Breckenridge's office.  The consultant may be able to give you their winscribe login if this is required.