For the attention of all GPs and Practice
Managers
Extension of online referral pathway for TIA patients from 1 December 2014
Link to form: https://referrals.southend.nhs.uk/HOT-WestEssex/.
Important note- Due to information Governance this link will only work from your work
computer or N3 network.
The online referral system for Transient Ischemic Attack (TIA) patients is being extended to
seven days a week, and replaces previous referral techniques. As of 1 December 2014,
patients presenting with features of a TIA (regardless of low or high risk) on all days of the
week must be referred via the online referral form, and will be seen at either Princess
Alexandra Hospital or Broomfield Hospital as appropriate.
TIA is a medical emergency and national guidelines call for all high risk patients to be seen
and treated within 24 hours of onset of symptoms and low risk patients to be seen and
treated within seven days of onset of symptoms. Valuable time is lost filling in referral
forms/typing letters and patients are not being seen within the timeframe.
The new online referral form has been used successfully in Southend and Broomfield
hospitals for 18 months and has been well received by GP practices. It is a simple online
form which automatically calculates ABCD2 risk and submits the referral to a dedicated
hospital inbox along with a confirmation receipt to your practice email address. The online
form is completed during the patient consultation and given the relevant information, the
system provides guidance on what the next steps are for the patient (information sheet) in
accordance with the calculated risk score.
This information will also be shared in the GP newsletter and on the West Essex CCG
intranet (nww.westessexccg.nhs.uk). Please note, full instructions are attached and a copy
of the newly revised TIA pathway and a poster to be displayed in all clinical areas, will be
sent out to all practices.
During the changeover period, fax referrals will remain temporarily operational.
Notes for Practice Managers:
1. Please cascade this to all staff.
2. Please remove all old stationery of TIA referral forms.
3. Please ensure all GPs in practices are aware of changes – Please clearly display the
poster attached in clinical areas.
4. Please save the link https://referrals.southend.nhs.uk/HOT-WestEssex/ on all
desktops or as a favourite in internet browsers for quick use.
5. Please ensure GPs are aware of the practice email account for referral receipts.
6. Please ensure GPs have easy access to a printer so the patient information sheet can be
printed and given to the patient.
Management checklist for professionals for suspected TIA.
1
Start Aspirin 300 mg (or Clopidogrel 300 mg stat then 75mg daily if
allergic to aspirin) immediately.
2
Start Simvastatin 40 mg if not on statin.
3
Ask patient to stop driving until assessed by stroke team.
4
If low risk, arrange blood tests – FBC, U&E,LFT, Glucose and
Cholesterol and forward to stroke contact if not on ICE.
5
If low risk, please do ECG and give ECG copy to patient.
6
Tell patient to expect a call within 7 days if low risk and 24 hours if high
risk.
7
Advise patient to call 999 if any recurrence while waiting for clinic
(FAST leaflet)
8
Send last prescription copy with patient.
9
If anyone has witnessed the episode please ask them to attend clinic
as well.
10 Currently, TIA clinic can only provide service to ambulatory patients. Please discuss
with stroke team if patient is not ambulatory for alternative method of reviews.
PAH: 01279 444455 ext.755.
Out of hours- Broomfield Acute Stroke Team: 01245 362000 #6555 2555.
ABCD² Risk Score
Low
High
Risk of further Stroke
1% at 2 days
1.2% at 7 days
3.1% at 90 days
8.1% at 2 days
11.7% at 7 days
17.8% at 90 days