Private pathology tests

With effect from 6th December 2010, any private pathology tests ordered on behalf of a patient will always be charged to the practice, rather than the patient.

So if we request a private pathology test we will need to take payment from the patient first.

Prices

Contact Karen Lodge: Tel. 0115 924 9924 ext. 63592.

Source: letter from Nottingham University Hospitals Finance Department, 24/11/2010

Traffic Lights

The Traffic Lights drug list has been taken off-line. The new reference source for traffic lights, local and national guidelines, and so on is:

• Nottinghamshire Formulary

Diabetes Services

Nottingham City PCT have provided this guide to local Diabetes Services:

• Guide to Diabetes Services (November 2010)

Clozapine information

Clozapine is a RED drug, prescribed, monitored and supplied by Nottinghamshire Healthcare NHS Trust. However, familiarity with the contents of this document will serve to protect patients treated with clozapine from adverse events associated with its use.

• Clozapine information (March 2010)

Varicose veins referrals

Varicose veins surgery is included within the policy for adult cosmetic procedures. Surgery for varicose veins is not barred completely by Nottingham City PCT but is subject to meeting a number of clinical criteria. The adult cosmetic procedures policy says that the PCT will commission surgical treatment of varicose veins only when one, or more, of the following clinical criteria are met:

• varicose eczema
• lipodermatosclerosis or a varicose ulcer
• at least two episodes of documented superficial thrombophlebitis
• a major episode of bleeding from the varicosity

These criteria equate primarily to Class 4 & 5 of the Nottingham/Derby Guidelines ‘Varicose Veins - who and what to treat’. Patients in Class 3 should only be referred if one, or more, of the following clinical criteria are met:

• At least two episodes of documented superficial thrombophlebitis
• A major episode of bleeding from the varicosity

Varicose vein referrals will now go through a Clinical Assessment Service to ensure they are suitable. Since we do not (yet) use Choose and Book we simply send our referrals in the usual way. But we will need to include information in our referrals to show that the patient fulfils at least one of the above criteria.

For your information:

• Nottingham/Derby varicose veins guidelines
• Cosmetic Surgery policy

Fertility Clinic referrals

The Fertility Clinic have produced a ten page document with an algorithm for referral, a referral form, and forms for the couple to complete in connection with Welfare Of The Child and a general questionnaire. All these now have to be submitted with the referral.

• Fertility Clinic Referral Forms

Tests required if patient has regular cycles:

• day 1-5 FSH/LH (within past 6 months)
• mid-luteal progesterone (within past 6 months)
• rubella status (within past 5 years)
• chlamydia status (within last 6 months)
• partner's semen analysis (within last 12 months)

Tests required if patient has irregular cycles:

• random FSH/LH (within past 6 months)
• TSH and prolactin (within past 6 months)
• rubella status (within past 5 years)
• chlamydia status (within last 6 months)
• partner's semen analysis (within last 12 months)

Advice has to have been given concerning:

• folic acid
• smoking
• alcohol
• weight loss if woman's BMI over 30

We can defer referral if history, examination and investigations normal in both partners and duration of infertility less than 18 months. But consider early referral if:

• woman: aged over 35 years, amenorrhoea/oligomenorrhoea, previous abdo/pelvic surgery, previous PIB/STD, abnormal pelvic exams
• man: previous genital pathology, previous urogenital surgery, previous STD, varicocele, significant systematic illness, abnormal genital exam