Reviewed on : 4 Apr 2019

Reviewed by : GP Gateway Editor

Expires : 4 Apr 2021

There are three referral routes for chest pain which is likely to be cardiac.

1. Dial 999 for Ambulance
2. Refer to the Rapid Access Chest Pain Clinic on the NHS eReferral Service
3. Refer to a Cardiology Clinic via the Referral Support Service.

Rapid Access Chest Pain Clinic

Inclusion criteria to be met for a referral to be accepted

ANGINA PAIN is when all three of the following are present;

• Constricting discomfort in the front of the chest, or in the neck, shoulders, jaw or arms
• Precipitated by physical exertion
• Relieved by rest or GTN within about 5 minutes

ATYPICAL PAIN can be classed as atypical if ONLY 2 of these are present

NON-CARDIAC PAIN is if ONLY ONE or NONE of these are present

Only patients with two or more features will be accepted for assessment in the RACPC

Exclusion Criteria (do not refer to RACPC)

• Unstable angina/suspected MI (chest pain at rest) – refer to hospital acutely via 999
• Chronic stable angina- refer to general cardiology clinic
• Recent coronary investigations within 12 months – refer back to previous cardiologist
• Valve disease or murmur – refer to general cardiology
• Patients who have exertional breathlessness but no pain can be referred to the general cardiology clinic if thought to be an “angina equivalent”.

The NHS eReferral Service is now the required method of referral however if for any reason you are unable to send it via this route then please email the form to uhcw.appointment@nhs.net

The GP practice should book an appointment via the NHS eReferral Service before the patient leaves the surgery.

If this is not possible, the practice should contact the patient with the appointment details, within 24 hours.

Please see link in right panel to read explanatory notes on these three referral routes.