Admissions

Do some Doppler's before referral. If Doppler's okay, review differential diagnoses
Dopplers. It's the district nurses at most surgeries that do Dopplers.

GPSIs

Specialised Outreach Clinics

Name	Location	Tel	Referral Criteria	How to refer
Suspected DVT? CIT DVT service CIT Venometer Service	Eccleshill Hospital or Shipley Community Hospital Debbie Cromack Practice Development Lead	Tel: 227515	●You must do a Well's score first Download it here ●If you answer yes to any of the exclusions or the patient scores 3 or more on the Wells pre-test risk assessment tool then we would request that those patients get sent directly to BRI ward 3 or 6 as they will fall in the high risk groups for DVT. ●The service provides a venogram to determine if there is one ●for people in whom you suspect a diagnosis ●for venometer testing only to prove or refute a diagnosis ●Please be aware that the patient will remain under your responsibility medically and that staff will ask how to refer back to you if the venometer is negative (eg if the patient will have to make another appointment at your practice or if they can simply return after the venometer test). We will fax the outcome of each referral back to the referring practice as a discharge summary	●click here to see the venometer pathway ●click here for the referral form ●scores 2 or below please telephone 322647 between the hours of 8.30am and 5pm Monday to Friday with the patients details, presenting symptoms and Well's score. ●telephone the referral ●referral form
Venous Ulcer Clinic	Wrose Idle and Shipley (just for North Bradford)	322162	●discuss with your own DNs first, get them to do dopplers	●referral form
Ayesha Clarkson Tissue Viability Nurse	City Wide	Eccleshill Clinic	●see notes below to see how she can help you	●referral form vascular

Consultants

Name	Location	Tel	Special Interest	How to refer
Mr. Vowden
Mr. Shaper
Mr. Wilkinson

Notes on the Tissue Viability Nurse

●Non-healing wounds:
     ►Failure to make expected progress
     ►For leg ulcers this may be at the 12 weekly review (PACE)
●Deteriorating wounds
●Underlying medical condition preventing/delaying healing:
     ►Venous disease
     ►Arterial disease
     ►Diabetes
     ►Renal or cardiac failure
     ►Diabetic foot ulcers (PACE)
●Ischaemic ulcers
●When the diagnosis is uncertain
●When pain management is difficult
●When exudate is uncontrolled
●Wounds that fall outside your field of knowledge or experience
●When the use of an "Advanced Product" from the formulary would seem to be appropriate or advice on. its use is required
●Contact dermatitis - referral for Dermatological opinion may be more appropriate
●Suspected malignancy- referral to Plastic surgery or Dermatology