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Pathways and Referral Guidance for GPs

Welcome to the ‘L&D GP Pathways & Referral Guidance’ section of the GP pages. This new section contains newly updated clinical pathways and referral guidance for GPs to refer to, before referring patients to the L&D for a specific service. Please visit this page regularly to keep updated on latest pathways updates and referral processes changes.

Open Access Endoscopy Pathway
We have recently updated guidance to primary care around our open access pathway, which allows GPs to directly refer patients for a gastroscopy or flexible sigmoidoscopy without a preliminary consultation with the Consultant/Endoscopist.  Find further guidance , including details of patients appropriate for open access referrals and information on actions taken post-procedure.

Please see below the most recent L&D Clinical Pathways and referral guidance:

Transfer from Anticoagulation Yellow Book to Patient Dosing Letter
Luton & South Beds GP Notfication.
Anticoagulation Contingency Form.
Anticogulant Therapy Record – Patient Letter

NIPE 2016-2017 standards for Examination of Baby Hip at the 6 week check by GP
According to new national NIPE 2016-2017 standards when GPs encounter an abnormal hip examination they should refer directly to orthopaedic surgeon (currently Mr Vermit Shoba). The baby needs to be seen within 10 weeks of age. As from now GPs should no longer request a hip scan for these babies but do an orthopaedic referral requesting the baby be seen by 10 weeks of age.

Please note that according to National NIPE standards ‘clicky hips’ are not considered to be screen positive(see attached). However these babies still need to be referred to the orthopaedic team as per our LOCAL guidance. In accordance with the above hip scan requests will be rejected by our team as of today. If hip risk factors are discovered that were missed at new born examination please liaise directly with NIPE lead Dr Claudia Chetcuti Ganado ( and she will be able to request the appropriate investigation for these patients.

Luton and Dunstable Hospital- Change to Glucose Tolerance Testing Guidance
Please find attached the new documents to support the change in guidance for Glucose Tolerance Testing for GP’s following the introduction of HbA1c for the screening of diabetes.

Please review this information which is relevant to all GP’S, there will be a change to GTT requesting on ICE which will go live on Thursday 7th September 2017 and these are the documents required to support these changes.