The Nephrology (renal medicine) team in Belfast Health and Social Care Trust have introduced a ‘referral for advice’ function for patients who receive renal care at the BHSCT

The aim is to ensure patients with CKD or AKI receive timely access to services during the COVID-19 pandemic, and also going forward in more general times.

We consider the following types of questions as ideal for this approach:
– Advice on existing CKD patients known/previous seen by a nephrologist
– Changes in GFR where patients are asymptomatic
– Changes in urine protein (ACR) levels
– Electrolyte problems in CKD (potassium, bicarbonate)
– Advice on structural kidney findings (multiple simple cysts/scars) on ultrasound or CT which can fall between ourselves and Urology colleagues.
All solid renal or bladder masses should be sent by red flag referral to Urology. All stone queries also to Urology.
– Drug dosage questions can usually be answered using the online resources such as BNF and the Renal Drug Handbook (available via HONNI-HSC library)

CCG REFERRAL FOR ADVICE
The CCG referral for advice function provides additional access for GPs to renal medicine advice. We aim to provide timely advice and consultation for current outpatients or potential future patient.
CCG ‘Referrals for Advice’ received out of hours will be answered on the next working day.
New outpatient referrals to the Nephrology team should be made via normal referral processes. We have found that we can often give advice in up to 40% of such patients but that this still requires a formal letter dictated and typed when we can often give typed responses or a phone call to the referring GP or practice.
We are aware that many GPs may not be familiar with CCG Referral for