Please click on the appropriate links below to download
General X-Ray request form (updated)
Letter Letter to accompany new x-ray request form
regarding bowel cleansing preparations (updated)
Open Access Ultrasound request form
Request for Ultrasound Scan in Pregnancy
TVS Open Access Gynae request form
Attendance information - Open Access (plain film imaging)
Attendance information - Open Access
Attendance Information - TVS Open Access Gynae
Scan March 2012
Referral guidelines can be found in the Radiology
section of this website, accessed through our clinical services.
Endoscopy (to be returned by post)
Short term closure of UHB for routine endoscopies
which are eligible for other providers.
UHBristol is entering a period of reduced endoscopy
capacity. The Trusts have approached Bristol, South
Gloucestershire and North Somerset CCGs to request that eligible
routine scopes be referred to other providers, and are not referred
to UHB for a short period.
This is a short term issue to ensure that capacity
continues to be available to scope urgent and 2WW patients quickly
over the next 3 months.
BNSSG CCGs have contacted other endoscopy
providers, and have confirmed that capacity is available. GPs
are asked to support UHB Endoscopy departments during this time by
referring suitable patients to other providers.
There are several options available to patients who
need endoscopy and the information below provides the latest
information on referral choices.
Please note that this does not change referral
routes for 2 week wait referrals, urgent referrals or patients who
do not meet the eligibility criteria for endoscopy at an
Routine Endoscopy Referral, options for BNSSG
- All endoscopy referrals (other than 2WW referrals) should be
submitted on one of the forms via eReferral.
- EGTC and PRIME also offer a duodenal biopsy service for
patients with suspected coeliac disease. These forms are based on
the Care UK referral form and are accepted by Emerson's Green,
PRIME or Nuffield so that patients referred using this form will
have a choice of provider.
Referral options are:
- Emerson's Green NHS Treatment Centre via
eReferral - fast access to upper and lower GI endoscopy but you
must complete the referral form in order to access this
service. This form can also be faxed directly to the provider.
- Prime Endoscopy (Westbury-On-Trym) via
eReferral- Prime will accept referrals on a Care UK referral form
(preferred option) or on their own referral form or a dictated
letter with all relevant details.
- Nuffield Hospital, Bristol - via eReferral.
Ideally also using one of the forms below.
The South Gloucestershire GP Referral Tool will be updated to
reflect this temporary change.
Please be assured this has been agreed with all Providers named
herein, in a number of forums where CCG staff are members and
present, these include:
- NBT Access and Performance Group
- UHBristol Access and Performance Group
- BNSSG RTT Programme Board
- BNSSG Partnership
Lower Gastrointestinal Endoscopy Referral Form
UK Routine Gastroscopy Referral Form
UH Bristol Colorectal request
UH Bristol Gastroscopy request
University of Bristol Dental Hospital referrals
Please see here for the dental
hospital's referral forms.
sinus Xray/CT sinuses