Rapid access diagnostic clinic referrals

Quick access to a range of diagnostic tests

Contact details

Gerraint Jones and Dr Luigi DeMichele
Tel: 020 7188 7188 (ext 55667). The phone is manned 9am-5pm on Monday-Friday. If calling out of hours, please leave a message and a member of the team will get back to you.
Mobile: 07393 763 157
Email: gst-tr.rapidaccessdiagnosticclinic@nhs.net

Download our referral form (Word 38Kb).

How to refer

For the full list of inclusion criteria, please see below.

Please complete the referral form (Word 38Kb) and email it to gst-tr.rapidaccessdiagnosticclinic@nhs.net

The service is also available on e-RS (Choose and Book)   

The team can be contacted on 020 7188 7188 ext 55667.

  • Before referring a patient to this service

    Patients aged 40 years or over are suitable for referral to this clinic. In addition to a full clinical assessment and examination, the GP is asked to arrange the following preliminary investigations before referral.

    All patients should have:

    • urinalysis
    • urgent blood tests - full blood count, electrolytes, renal function, liver function tests, bone profile, HbA1c, thyroid function test, CRP
    • urgent chest x-ray - please include full clinical details and mark the request ‘very urgent’ to ensure it is reported without delay.

    In addition, and where appropriate, patients with abdominal symptoms and/or weight loss may also require:

    • coeliac antibodies, serum amylase, gamma GT
    • CA125 and urgent pelvic ultrasound scan (where this is available in a timely way) in women over 45 years
    • abdominal ultrasound scan (if appropriate to do before referral please ensure requested urgently and the result is included with the referral).

    If these tests do not result in an identified cause of the patient’s symptoms, the patient should be referred to the rapid access diagnostics clinic.

    Please note: it will be difficult to make a clinical assessment of your patient without these preliminary investigations. We will not be able to accept the referral without the results of these investigations.

  • Referral criteria

    Patients aged 40 years or over with one or more of the following unexplained symptoms may be referred to the rapid access diagnostic clinic:

    • thrombocytosis
    • general malaise/fatigue
    • unintentional weight loss (greater than 5% recorded weight or clearly reported by patient/carer)
    • non-specific abdominal symptoms of more than four weeks duration (which do not fit into an established urgent suspected cancer referral pathway).

    New onset or unexplained worsening of breathlessness (please take steps to rule out undiagnosed heart failure, IHD, thrombo-embolic disease, COPD and infection – but note that previously diagnosed IHD/heart failure/COPD do not preclude referral)

    Persistently abnormal laboratory tests (tested on at least two occasions) which are not readily explicable including:

    • significantly elevated alkaline phosphatase (more than twice the upper limit of normal)
    • raised CRP (or ESR/plasma viscosity)
    • increased calcium
    • unexplained worsening of pain (especially back pain).
    • significant GP concern regarding a possible cancer diagnosis, where there is no clear urgent referral pathway (for example, unexplained DVT, paraneoplastic syndromes, etc).
  • Urgent referrals

    A number of symptoms indicate a specific cancer diagnosis (for example cough, abnormal vaginal bleeding, change in bowel habit, dysphagia and haematuria. Any patients meeting the urgent suspected cancer referral guidelines for any tumour sites should be referred using the appropriate 2WW urgent suspected cancer referral pathway and referral forms.