Referrals - information for clinicians only

Referrals can be sent to the Consultant in Infectious Diseases (ID) at the Bone Infection Unit or to a named surgeon at the Nuffield Orthopaedic Centre. Regardless of whoever receives the referral, the whole team will be usually be involved.

A strict appointment system operates, and referrals are prioritised on clinical need based on the information supplied by the referring medical practitioner.

Exclusions

We cannot take acutely septic / unwell patients from other trusts. If a patient needs an urgent drainage and stabilisation; this should be done locally.

We cannot routinely accept out-of-area referrals for:

• pressure sores
• spinal infection
• head and neck osteomyelitis
• thoracic wall osteomyelitis; or
• diabetic foot infection

but we may be able to discuss such cases at our MDT meeting.

There is an alternative service for children under 16 years - please see below.

We do not accept referrals exclusively and specifically for the administration of OPAT / Home IV therapy.

Suggested investigations

Patient should attend with the results of FBC, U&E, LFT, and all relevant microbiology results.

Plain X-ray is generally the minimum requirement for all referrals (except spinal infection where it may not be useful).

X-rays / MRI imaging must accompany referral in digital form. Please arrange for your PACS team to transfer them to the IEP server.

Administration requirements

1. Send a referral letter to the Bone Infection Unit consultant by email. This should include an indication of the clinical complexity, including presenting problem, past medical and surgical history, antibiotic exposure and allergies, MRSA or other multi-resistant organism status and current medication including antibiotics. This is essential to allow us to allocate the appropriate Infectious Disease Consultant, Orthopaedic Consultant and, if relevant, Plastic Surgery Consultant to your patient.
2. Please ensure demographic details for the patient are up-to-date and complete, and include a contact telephone number for the patient. Please see our proforma for guidance on the information that needs to be included:
   BIU Referral Proforma (Word, 48 KB)
3. State if an interpreter is required including language/dialect.
4. Please ensure all imaging has been transferred to the IEP server. To do this contact your local PACS team.
5. Transport (if applicable) to our Trust must be booked by the GP once appointment confirmed.
6. Your patient will be seen by a member of our team, including doctors in training, who will discuss the case with a consultant. All new patients will be reviewed by a consultant.
7. Appropriate investigations and follow-up will be arranged at your patient's clinic visit.
8. Admission to the Bone Infection Unit from outpatients will only occur if your patient requires emergency surgery.
9. All letters from our clinic are sent to your patients GP and/or the referring surgeon/physician.
10. Correspondence will normally be copied to the patient unless they opt not to receive correspondence.

Alternative services

To refer children under the age of 16 years with bone and joint infection, please contact the Bone Infection Unit.

Tel: 01865 737872

Booking details

All referrals are reviewed by the relevant clinicians prior to the clinic.

This may result in a patient appointment being re-assigned to any of the consultants for the specialty, or a member of their teams, to ensure that the most appropriate clinical treatment is provided.