WEXHAM PARK HOSPITAL (WPH) - FRIMLEY NORTH

MEDICINE (WPH)

Ambulatory Emergency Care Unit (AECU) Wexham

Mon - Fri:

9.00 – 22.00

Wknds & BH:

9.00 - 21.00

Level 1, EAC (above ED)

07384 527 685 or via switchboard (0300 614 5000).

(Outside of these hours calls are taken by the site manager available through switchboard - 0300 614 5000 or on-call Med Reg via switchboard Blp 4724)

Senior medical presence cannot always be guaranteed on the unit. Calls asking for the Med Reg for advice should still go through switchboard to bleep them, as the unit is unable to transfer the call.

** PLEASE NOTE - This is not a walk-in service – please ensure you phone the referral telephone lines in the first instance.  

AECU Inclusion Criteria:

All medical conditions will be considered for referral. If uncertain whether a patient is suitable for referral, discuss the case with the AECU / Medical team (Registrar or Consultant available via the referral line if needed).

AECU Exclusion Criteria:

· Any patient presenting  with a time critical condition, requiring immediate treatment upon arrival at hospital, MUST continue to be pre-alerted to ED.
· Any patient with suspected (or confirmed) Covid-19 symptoms e.g. 'Flu-like illness; New onset dry, persistent cough; Fever.
· Any patient presenting with a frailty syndrome should be referred via the Community Frailty Assessment Pathway.
· Abdominal pain.
· Active cardiac chest pain with or without ECG changes.
· Active diarrhoea.
· Active PR bleed.
· Lower Back pain.
· Complications following a recent surgical procedure.
· Fall with suspicion of fractures, multiple fractures or c-spine tenderness.
· Head injury.
· Acute confusion or Mental health problems.
·Suspected Neutropenic sepsis.
· Pregnant patients presenting with PV bleeding or a condition best managed by maternity.
·Under 16 yrs old (or 16-17 yrs and known to the paediatric team).
·Urinary retention.
·Patients seen in an outpatient setting with a documented decision to admit by their speciality team.
·Any other presentation considered unsuitable for referral, by the AECU/medical team

SURGERY (WPH)

Ambulatory Emergency Care Unit (AECU) Wexham

Mon – Fri:

09:00-17:00

Ambulatory unit of the new Emergency Care building

Surgical Ambulatory Care Coordinator: 07468 354436 (Outside these hours calls are taken by the Surgical SHO on-call Bleep 4422 via switchboard – 0300 614 5000).

Cover by a consultant or registrar surgeon 13:00 to 18:00.

AECU Inclusion Criteria:

· Abscesses – back of the neck to above knee and peri-anal (incision and drainage possible under local anaesthesia, incision and drainage requiring general anaesthesia will be brought back subject to theatre and bed availability.)
· Right iliac fossa pain.
· Right upper quadrant pain.
· Small volume PR bleed – haemodynamically stable.
· Mild diverticulitis.
· Painful jaundice.
· Painful non-obstructed hernia.
· Post operative or wound issues.
· Early supported discharge for drain review, repeat radiological or blood tests.
· Patients who were sent home to reattend after being assessed by the on-call team if they are stable. These patients can return the next day for clinical review, further investigations or theatre (subject to CEPOD availability).

AECU Exclusion Criteria:

·Patients with poor mobility.
· Urological emergencies/problems.
· Acute confusion or patients presenting with symptoms of acute mental health crisis.
· Patients in severe pain.
· Aged under 16 years.
· NEWS score above 3

GYNAE (WPH)

Urgent Gynae Care Centre (UGCC)

7 days a week:

Mon - Sun

08:00 - 20:00

Ward 20, Green Zone

0300 6154429

The service has been increased to provide a 7 day a week service.

**PLEASE NOTE – UGCC/EPAU/EPU are NOT Walk in Services, please ensure you call the team in the first instance.

Early Pregnancy

UGCC Inclusion Criteria:

· Up to 15+6 weeks. From 16 weeks onwards, send to maternity assessment centre (MAC) (phone: Wexham Park- 0300 615 4520). 
· Please do a urine pregnancy test and ensure patient is pregnant. 
· If possible send Serum HCG and Serum Progesterone. This helps to speed up diagnosis and discharge.

Emergency gynaecology

UGCC Inclusion Criteria:

· Over 16 years of age.
· Any gynaecology related symptoms that need urgent management.
· Post operative patients up to 14 days with surgical related complications (not for suture removal)
· Only mobile, stable and independent patients.
· Bleeding after recent pregnancy where retained products of conception is suspected.
·Acute Batholin’s abscess

UGCC Exclusion Criteria:

· Pregnancy more than 16 weeks – Please refer to MAC.
· Haemodynamically unstable patients.
·Any suspected surgical or medical patients.
· Post-menopausal bleeding   - Please refer to rapid access clinic.
· Any patient who is not mobile and independent and cannot sit unaided in a chair.    

PAEDIATRICS (WPH)

Paediatric Admission Unit (PAU)/ Advice Line

Mon - Fri
09:00 -18:00

07919 175 643 (Outside of these times please ask for the Paediatric Registrar via Switchboard - 0300 614 5000 Bleep 4940).

Paediatric Advice and Urgent Referral Process Flow Diagram- July 2021

Acute referrals to Paediatrics should go via this number.

PAU Inclusion Criteria:

· All acute medical referrals of children and young people up to the age of 16 years will be considered for referral apart from the exceptions below. If uncertain whether a patient is suitable for referral, discuss the case via the contact numbers provided for advice.

PAU Exclusion Criteria:

·Any patient presenting with a time critical condition, requiring immediate treatment upon arrival at hospital, MUST continue to be pre-alerted to ED.
· Babies under 10 days of age with feeding difficulties or jaundice who are usually seen on Post Natal.
· Young people between 16-18 years with new diagnoses of diabetes or cancer, or who present with a problem related to a condition for which they are still under paediatric outpatients.
· However, if there is any doubt about if a PAU referral is appropriate then it should be discussed via the contact numbers

OTHER WPH urgent care services can be found here: https://www.fhft.nhs.uk/gps/gp-centre/urgent-advice(including the Frailty details below):

FRAILTY (WPH)

Integrated Frailty Liaison Team

Mon - Sat:

07:30 - 18:00

Sun:

07:30 - 16:00

Consultant: 07787 275775

Email:fhft.frailtyteamwexham@nhs.net

All referrals should go via this number.

This phone line takes referral calls for anyone over 65 years and will decide whether appropriate for ED or Frailty team.

• Patients aged over 65 years who score positively on the Frailty Indicator tool, with a Rockwood score of 5 and above:

• Frail

• Reduced mobility

• Altered level of consciousness

• Incontinence

• Lots of medication

• Patients aged over 65 years from a care home

• Patients aged over 90 years with co-morbidities

Exclusion criteria

• Aged 65 or under

• Single organ pathology with clear specialty need*

• Suspected patients with TIA/stroke

• Chest pains /ACS

• Head injury with LOC,

• Suspected fractured NOF

• Ischaemic Limb

 EMERGENCY DEPARTMENT (ED)

EMERGENCY DEPARTMENT (ED)

If you are referring to SDEC please ensure that you follow the appropriate referral process and if you direct to specialty, please ensure that the speciality has accepted the patient before sending them with a letter.

A referral form is now available on DXS for ED. This has been developed to improve communication between primary and secondary care and should follow a phone call being made to the specialist and not be instead of. It ensures patients being referred to hospital as an emergency have the relevant supporting documentation and ‘hand over’ from primary care colleagues.

The form can be found on DXS Landing Page “ED and URGENT CARE” or can be found by searching with the terms “FHFT ED”, “Emergency”.

The ED form has an option at the top for users to choose which site they would like to refer to and the respective email address for WPH or FPH, the form. This form can be emailed directly from DXS to the specified ED nhs.net inbox these inboxes are:

FPH: fhft.fphed@nhs.net

WPH: fhft.wphemergencydepartment@nhs.net

This is a Minor Injury service only.

Patients with minor illness that attend will be assessed and redirected to their GP practice or pharmacy.

The minor injury service is led by specialist nurses with prescribing capability. The clinicians provide telephone and video consultations in addition to face to face.

The service accepts walk-ins, but if possible, please contact the clinician in charge via the mobile number 07773 018190 to support virtual management or a booked appointment.

Some common conditions or illnesses that can be treated at Bracknell Urgent Care Centre include: 

Sprains and strains

Suspected fractures and broken limbs

Minor head injuriesCuts and grazesBites and stings

Minor scalds and burns

Ear and throat infections

Skin infections and rashes

Eye problems

Coughs and colds

Feverish illness in adults

Feverish illness in children

Abdominal pain

Vomiting and diarrhoea

Emergency contraception

We are unable to see patients for the following:

Long standing medical conditions that are managed by a patient’s own GP

Dental problems

Sick notes/fit notes

Repeat prescriptions

Strong analgesia, benzodiazepines, antipsychotics, sleeping tablets or specialised medications prescribed by a consultant