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Acute Kidney Injury (AKI)

AKI is a rapid reduction in kidney function resulting in a failure to maintain fluid, electrolyte and acid-base balance
Adult Malnutrition and Oral Nutritional Supplements. About MUST scores

This page has information on the role of a dietitian with links to further information.
Advance Care Planning, ReSPECT Forms, Advanced Decision to Refuse Treatment

The importance of patients and families having the opportunity to share their priorities for their future care is crucial particularly around times such as pandemics. To assist you with this an electronic ReSPECT has been developed. Also please find some helpful updates and reminders that may be of use.
Advice & Guidance from Secondary Care and Psychiatry

Information about seeking advice & guidance from secondary care to avoid unnecessary referrals and safely obtaining timely and safe management advice. Consultant Connect service. Urgent Connect GP Liaison Service
After COVID: POST COVID Syndrome LONG COVID (Adult)



A guide to management pathways, referral routes and support for Post Covid Syndrome (Long Covid)
Ambulatory Pleural Clinic

The Ambulatory Pleural clinic at UHCW NHS Trust for lung / respiratory disease
Anaemia (Children)

Anaemia is a problem in which the body does not have enough healthy red blood cells.
Anti-Coagulation Clinic

Atrial fibrillation is the commonest cause for GP referral to anticoagulation services.
Antinuclear Antibodies ANA (MSK Rheumatology)

The sensitivity and simplicity of an ANA test makes it extremely popular initial test to evaluate for lupus.
Area Diabetes Resources Page

Central resource page for management and referral information for Diabetes mellitus and its complications
B12 and Folate Testing

A diagnosis of vitamin B12 or folate deficiency anaemia can often be made based on symptoms and the results of blood tests.
Back Pain: Suspected Ankylosing Spondylitis & Spondyloarthritis (MSK Rheumatology)

Ankylosing Spondylitis (AS) is a rheumatic disease that causes arthritis of the spine and sacroiliac joints.
Bariatrics & Obesity Surgery (Specialist Weight Management Service)

Bariatrics is the branch of medicine that deals with the causes, prevention, and treatment of obesity.
Behaviour Problems in Nursing Homes (CHESS Scheme only)

Elderly Mentally Infirm (EMI) support system for CHESS Scheme for Nursing Homes
Benign Skin Lesions (including Sebaceous Cysts)

A swelling in the skin arising in a sebaceous gland, typically filled with yellowish sebum.
Blood Test Appointments (Online and Domiciliary Requests)




On line booking of blood tests in Coventry, Rugby & North Warwickshire. Blood tests (phlebotomy) across Warwickshire are provided by the Coventry and Warwickshire Pathology Network
Cardiac Rehabilitation

Cardiac rehabilitation is a programme of exercise and information sessions following a heart attack, heart surgery or procedure.
Carotid Artery Disease Asymptomatic

A carotid endarterectomy may be needed if one or both of your carotid arteries become narrowed because of a build-up of fatty deposits (plaque).
Chest Pain (Cardiac) – Rapid Access Chest Pain Clinic

The main causes of chest pain include angina, ACS (including myocardial infarction), acute pericarditis, pneumonia, pulmonary embolism, pneumothorax.
Chronic Kidney Disease (CKD)

Chronic kidney disease (CKD), also known as chronic renal disease, is progressive loss in kidney function over a period of months or years.
Chronic Obstructive Pulmonary Disease – Spirometry




Chronic Obstructive Pulmonary Disease (COPD) includes chronic bronchitis, emphysema and chronic obstructive airways disease.
Cluster Headaches

Cluster headaches are excruciating attacks of pain in one side of the head, often felt around the eye.
Coeliac disease

Coeliac disease is a common digestive condition where a person has an adverse reaction to gluten.
Community Ambulatory Service (ECG – Holter and Event Recorder)



Community Ambulatory Electrocardiogram (ECG) service has been developed for Holter monitoring and Event Recording
Community Dermatology Service – Adult (Community Assessment Service CAS)


A community based service for advice, management and education in common skin conditions
Community Diabetes and Lipid Clinic – GpwSI Clinic

Community management advice for difficult diabetic and lipid cases
Connective Tissue Disease (MSK Rheumatology)

Connective Tissue Disease (CTDs) is any disease that targets the connective tissues within the body.
Constipation – adults

Constipation is a common condition that affects people of all ages. It can mean that you're not passing stools regularly or you're unable to completely empty your bowel.
Continuing Healthcare (CHC) Assessment

NHS Continuing Healthcare (CHC) is a package of care for adults aged 18 or over which is arranged and funded solely by the NHS
Dementia – Admiral Nurse Service

Coventry and Rugby have an Admiral nurse service in conjunction with the NHS Coventry and Rugby CCG, Dementia UK and Coventry University.
Dementia POP Up Clinics (Dementia Navigators) & Dementia Connect Service


The Dementia Pop Up Clinics run by the Alzheimer’s Society offer appointments at practices across Coventry and Rugby.
Diabetes Care & NHS Diabetes Prevention Programme (DPP)

Personalised support to reduce their risk of Type 2 diabetes including education on healthy eating and lifestyle, help to lose weight and physical exercise programmes
Diabetic Eye Screening Service for Retinopathy

Diabetic retinopathy, also known as diabetic eye disease, is when damage occurs to the retina due to diabetes.
Dupuytrens Disease

Dupuytren’s contracture (Dupuytren's disease) is a condition that affects the hands and fingers.
Ebola Virus

Ebola virus disease is a serious illness that originated in Africa, where there is currently an outbreak.
Eczema & Use of Emollients (Community Assessment Service CAS)

Eczema is a condition that causes the skin to become itchy, red, dry and cracked. It is a long-term (chronic) condition in most people, although it can improve over time, especially in children.
Falls Service (Community Physiotherapy & Care of the Elderly Referral)




Anyone can have a fall, but older people are more vulnerable and likely to fall, especially if they have a long-term health condition.
Familial Hypercholesterolaemia Service

Identification of patients and families at raised CV risk from Total Cholesterol of 9mmol/l or more
Ferritin high

High ferritin levels may suggest a disorder that has led to an excess accumulation of iron, resulting in iron overload.
Ganglion (Hand & Wrist)

A ganglion cyst is a fluid-filled swelling that usually develops near a joint or tendon.
Gastro-intestinal blood loss

Gastrointestinal bleeding (GI bleed), also known as gastrointestinal hemorrhage, is all forms of bleeding in the gastrointestinal tract.
Genetic Services

Clinical genetics is a specialist regional service based at Birmingham Women’s Hospital.
Giant Cell Arteritis / Temporal Arteritis (MSK Rheumatology)

Giant cell arteritis (GCA) is a large vessel vasculitis that affects 2.2 per 10,000 people each year in the UK
GP Liaison Nurse & Consultant Connect Advice



The GP Liaison Service offers a single point of contact for emergency referrals or pre referral advice
Guidance on Allergy and Specific IgE testing

Allergic disease is a clinical diagnosis with tests used to help confirm or refute a diagnosis - allergy is NOT diagnosed by allergy tests
Haemoglobinopathy Screening

“Opportunistic” haemoglobinopathy screening (not including national antenatal or neonatal screening programmes)
Hallux Valgus – Bunion

A bunion is a bony deformity of the joint at the base of the big toe. The medical name is hallux valgus.
Hereditary Thrombophilia Screening

It is suggested that General practitioners DO NOT request Thrombophilia screens without review of this guideline AND discussion with haematology.
Hirsutism

Hirsutism is excessive hair growth in certain areas of the body. It's a problem that mainly affects women.
HIV Testing Clinical Algorithm


This page contains information and pathway details for HIV clinical testing
Hyaluronic injections for osteoarthritis

Osteoarthritis is a condition that causes joints to become painful and stiff. It's the most common type of arthritis in the UK.
Hyperhidrosis of Palms and Axillae

Hyperhidrosis is a common condition in which a person sweats excessively.
Hyperlipidaemia and Cardiovascular Risk

Hyperlipidaemia is abnormally elevated levels of any or all lipids and/or lipoproteins in the blood.
Hypertension

Stage 1 hypertension: Clinic blood pressure is 140/90 mmHg or higher and subsequent ambulatory blood pressure monitoring (ABPM) daytime average or home blood pressure monitoring (HBPM) average blood pressure is 135/85 mmHg or higher. Stage 2 hypertension: Clinic blood pressure is 160/100 mmHg or higher and subsequent ABPM daytime average or HBPM average blood pressure is 150/95 mmHg or higher. Severe hypertension: Clinic systolic blood pressure is 180 mmHg or higher or clinic diastolic blood pressure is 110 mmHg or higher.
Infectious Diseases & Tuberculosis (TB)

The infectious diseases (ID) UHCW looks after adult patients (over 16) with all types of infection or suspected infection. We are a regional centre for infectious diseases and tropical medicine.
Inflammatory Bowel Disease IBD – Crohn’s Disease & Ulcerative Colitis

Inflammatory bowel disease (IBD) is a term mainly used to describe Ulcerative Colitis (UC) and Crohn's Disease (CD)
Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a common, long-term condition of the digestive system.
Jaundice & Liver Disease

Liver disease doesn't usually cause any obvious signs or symptoms until it's fairly advanced and the liver is damaged.
Knee Arthroscopy

An arthroscopy is a type of keyhole surgery used both to diagnose and treat problems with joints.
Lactose intolerance in adults

Lactose intolerance is a common digestive problem where the body is unable to digest lactose, a type of sugar mainly found in milk and dairy products.
Living Well Project

The Living Well Pilot Project is a new service based at Coventry Myton Hospice for adults living with a life limiting illness who are registered with a Coventry GP.
Low Back Pain


These are guidelines for most patients most of the time. Like all guidelines, there are exceptions. Acute back pain is for < 6 weeks, chronic > 6 weeks
Milk intolerance

Lactose intolerance is a common digestive problem where the body is unable to digest lactose, a type of sugar mainly found in milk and dairy products.
Monkeypox July 2022

This statement has been agreed by the UK public health agencies: UK Health Security Agency, Public Health Scotland, Public Health Wales and Public Health Agency Northern Ireland.
Neurophysiology: Nerve Conduction Studies (NCS)

Accepts NHS E-referrals for nerve conduction testing for carpal tunnel screening and ulnar nerve screening at the elbow or wrist ONLY. This is not an EMG service.
Paediatric Dermatology Service


Specialist advice in the community on the management of common paediatric dermatological conditions
Pain Management Services

Pain Management Solutions works with each patient to support them in finding the most effective and evidence-based approach to improving their ability to manage their pain on a day-to-day basis.
Palliative Care Services



Palliative care is a multidisciplinary approach to specialized medical care for people with serious illnesses.
Paramedic Acute Visiting Service (PAVS)


Practices can request a Paramedic to visit a patient at home on behalf of a GP. The key objective is to reduce avoidable hospital admissions by providing a timely response to patients requiring a visit, and ensuring patients are cared for at home if appropriate.
Paraproteins

A paraprotein can have many causes—some serious but others unlikely ever to cause any problems.
Parkinson’s Disease

Parkinson's disease is a condition in which parts of the brain become progressively damaged over many years. It can cause a wide variety of both movement (motor) and non-motor symptoms. Management becomes more complex as the disease progresses.
Parkinsons Disease Nursing Specialist Service

The PDNS care for Patients (and their carers) who are affected by Parkinson's Disease and associated neurological disorders
Pelvic Health Physiotherapy COCHC – RKB


Pelvic physiotherapy services provided at the City of Coventry Health Centre by UHCW
Penile Implants

A penile implant is a medical device that is custom-fit and surgically placed into a penis.
Pernicious Anaemia

Pernicious anaemia is associated with autoimmune atrophic gastritis which has an increased risk of gastric cancer.
Physiotherapy Services – MSK Hub and Integrated Pathways



Physiotherapy helps to restore movement and function when someone is affected by injury, illness or disability. It can also help to reduce your risk of injury or illness in the future.
Podiatry

Podiatrists are health care professionals who have been trained to prevent, diagnose, treat and rehabilitate abnormal conditions of the feet and lower limbs.
Pregnancy – Exposure to Chickenpox or Shingles

Complications of chicken pox in pregnancy include severe maternal varicella and congenital varicella syndrome.
Primary Care Initiation of Direct Oral Anticoagulants (DOACs) for Stroke Prevention in Atrial Fibrillation (AF)

Guidance and information regarding initiation of DOACs
Prostate specific antigen

Prostate-specific antigen, or PSA, is a protein produced by cells of the prostate gland.
Psoriasis (Community Assessment Service CAS)



Psoriasis is a skin condition that causes red, flaky, crusty patches of skin covered with silvery scales.
Psoriatic Arthritis (MSK Rheumatology)

Psoriatic Arthritis can cause progressive joint damage and loss of function.
Respiratory Diagnostic Service (Community Diagnostic Centre)



As part of the development of a community diagnostic centre, UHCW NHS Trust has launched a respiratory diagnostics service.
Respiratory Physiotherapy Outpatient Services George Eliot Hospital

A Secondary Care Outpatient Service for Warwickshire registered patients
Respiratory@home Virtual Ward

Referral for virtual monitoring of at risk suspected COVID-19 cases and those with long term respiratory conditions with pulse oximetry [formerly known as COVID Oximetry@home (virtual Ward)]
Rheumatology – Early Arthritis Clinic

Early Arthritis Clinic allows rapid access to Rheumatology services for assessment of patients with painful, stiff or swollen joints which may represent the onset of rheumatoid arthritis.
Scarlet Fever and Invasive Group A Streptococcus (iGAS) Infection

There is a higher than expected national increase in notifications of invasive group A streptococcus (iGAS) and scarlet fever. Scarlet fever and iGAS infection are both notifiable diseases
Seborrhoeic Dermatitis

Seborrhoeic dermatitis is an eczema affecting the eyebrows, anterior scalp, nasolabial folds, ears, axillae and groin.
Sharps / Needlestick Injury

Injury from used needles and syringes found in community settings arouses much concern.
Shingles Vaccination (Risks of Live Vaccination in Immunocompromised Patients)

For full details see The Green Book (shortcut below)
Sleep Clinic



Treatments and services for Sleep Apnoea and related conditions offered at the Sleep Medicine department.
The Myton Hospices

About local hospice services for enhancing quality of life when cure is no longer an option
Thyroid Function Testing Protocol – Results Management & Referral

Want to know more about Thyroid Function Tests? When does Free T4 measured in the laboratory? Protocol on Low TSH levels - when to repeat and when to refer to thyroid clinic?
Transient Ischaemic Attack (TIA) and Stroke (age over 16)

NICE advise assessment by specialist within 24 hours
Transient Loss of Consciousness (TLoC) in over 16s

Local guidelines for management and referral of transient loss consciousness
Trigger Finger – Adults

Trigger finger is a condition that affects one or more of the hand's tendons, making it difficult to bend the affected finger or thumb.
Tumour Markers in Cancer Diagnosis

With respect to primary care, the only tumour markers cited in the NICE Urgent Cancer Referral Guidance that should be requested to support diagnosis of possible cancers is Ca-125 and PSA
Type 1 Diabetes Mellitus (Paediatric)


Referral guideline for rapid referral of suspected type 1 diabetes to reduce the risk of diabetic ketoacidosis
UHCW Hospital at Home Services


UHCW Hospital@Home Pathways. Details of UHCW outreach services to treat patients in their own environment with specialist nurse teams to treat and monitor certain conditions.
Urgent Treatment Centres UTCs Coventry & Warwickshire ICB




A summary of UTCs in Coventry & Warwickshire
Urinary Tract Infection (UTI)

Urinary tract infections (UTIs) are common infections. In order to avoid misdiagnosis of UTI and the subsequent overtreatment / misuse of antibiotics please adhere to the following principles when using dipsticks.
Vitamin D Deficiency

Vitamin D blood levels should only be tested with symptoms indicative of rickets, osteomalacia or symptomatic hypocalcaemia. If deficiency is found with these symptoms, a course of high dose replacement therapy should be prescribed