Gloucestershire Hospitals NHS Foundation Trust
Guidelines for referral to Rapid Access Chest Pain Clinic
At Cheltenham General /Gloucestershire Royal Hospital
The clinic will be the joint responsibility of the seven countywide cardiology
consultants, Drs Viv Challenor, David Lindsay, Mark Petersen, Rafe ChamberlainWebber & Zafar Khan, Sylvia Siedlecka, Bogdan Nuta
The following guidelines have been developed to make the most efficient use of
resources /expertise available and hopefully keep referral numbers manageable to
fulfill the maximum two week planned wait.
REFERRAL PROCESS

Referral will be made by General Practitioners completing a Rapid Access Chest Pain
Clinic (RACPC) proforma. This form requires minimal information for speed of
referral, an accompanying letter is not required. The proforma should be faxed to
01242 776655 (the dedicated number printed at the head of the pro-forma). A
contact telephone number for the patient must be given so that confirmation of the
time/date of appointment can be given within the next 24 hours.

Patients must have experienced recent onset chest pain thought to be cardiac in
origin of recent onset (i.e. within three months or so).

General Practitioners should, where possible arrange for routine blood investigations
(FBC, U&E, GLUCOSE, LIPIDS, TFT) to be performed prior to the clinic visit.
The results from these investigations will then be obtained by RACPC staff before
the clinic appointment.

Patients with established ischaemic heart disease may be referred to RACPC so long
as they are no longer under active follow-up within cardiology & as long as the
symptoms are genuinely recurrent or exacerbated.
PLEASE DO NOT REFER…..

Patients suspected of having acute coronary syndromes (acute myocardial
infarction or unstable angina) should not be referred to the RACPC, but should
be referred to the admitting hospital medical team in the normal manner.

Only under exceptional circumstances should women aged under 40 and men under
30 be referred to the RACPC, as the probability of coronary disease in these groups
is extremely low. If in doubt please contact the team beforehand.
1
Gloucestershire Hospitals NHS Foundation Trust
WHAT YOU SHOULD EXPECT FROM THE RACPC SERVICE
 It is intended that all patients will be seen at the RACPC within a maximum of
two weeks from the date of their referral, and it is hoped that the median time
will be considerably shorter.
 Clinics will be held at both Cheltenham General and Gloucester Royal
Hospitals and patients may be required to attend either based on appointment
availability.
 The RACPC will be staffed by a Nurse Practitioner or Nurse Specialist or a
Clinical Assistant.
 Following clinical assessment the patient may undertake an exercise ECG test
if appropriate.
 A summary, diagnosis and management plan for the patient will be faxed back
to the GP’s surgery within 24 hours of their RACPC appointment.

It is anticipated that some patients may require urgent admission from the
RACPC and this will be arranged, although it is to be stressed that the RACPC
is not suitable for patients suspected of having acute coronary syndromes.
Please feel free to discuss any queries regarding referrals with:
Sandra Wheeler – Nurse Practitioner or
Alison Halliday –Nurse Specialist
On 08454 228281 or 08454 228437
Dr Mark Petersen
Consultant Cardiologist
Sandra Wheeler
Nurse Practitioner
Reviewed November 2008
2