Has any murmur detected been investigated? Haemoglobin Is patient at high risk of diabetes? --- (BMI 30) ≥ HbA1c HbA1c > 69mmol/mol (if diabetic or high risk of diabetes) Threshold for referral Smoking Status «Pat.EncValue{field:=SMOKING --- (required for New Devon CCG Optimising Referrals LES) STATUS;lates» If smoker, has patient been advised that they should ideally be smoke free for 8 weeks prior to surgery? Body Mass Index (BMI) --- (required for New Devon CCG Optimising Referrals LES) Haemoglobin: Hb < 130g/L male or Hb < 120g/L female (not related to chronic disease) Is the patient diabetic?: «Pat.Readcodes{filter:=C10,C100,C1000,C10» Primary Reason for Referral: (an opening statement outlining the question the GP wishes to be answered). Referral letter: (Include any advice or management plans, or attach physio/ESP referral letter) «Pat.RefText» Relevant Past Medical History: «Pat.Readcodes{problems;}» «Pat.Readcodes{current:=50y;type:=Non-Pat» Current Medication: «Pat.CurrRepeats{current:=12m;fulldose:=Y» «Pat.CurrAcutes{current:=3m;fulldose:=Yes» Allergies: (Medication or other adverse effects) «Pat.Allergies{current:=12m;}»
Has any murmur detected been investigated? Haemoglobin Is patient at high risk of diabetes? (BMI ≥ 30) --- HbA1c (if diabetic or high risk of diabetes) HbA1c > 69mmol/mol Threshold for referral Smoking Status (required for New Devon CCG Optimising Referrals LES) «Pat.EncValue{field:=SMOKING STATUS;lates» --- If smoker, has patient been advised that they should ideally be smoke free for 8 weeks prior to surgery? Body Mass Index (BMI) (required for New Devon CCG Optimising Referrals LES) --- Haemoglobin: Hb < 130g/L male or Hb < 120g/L female (not related to chronic disease) Is the patient diabetic?: «Pat.Readcodes{filter:=C10,C100,C1000,C10» Primary Reason for Referral: (an opening statement outlining the question the GP wishes to be answered). Referral letter: (Include any advice or management plans, or attach physio/ESP referral letter) «Pat.RefText» Relevant Past Medical History: «Pat.Readcodes{problems;}» «Pat.Readcodes{current:=50y;type:=Non-Pat» Current Medication: «Pat.CurrRepeats{current:=12m;fulldose:=Y» «Pat.CurrAcutes{current:=3m;fulldose:=Yes» Allergies: (Medication or other adverse effects) «Pat.Allergies{current:=12m;}»
DRSS-referral-template-V5-2017-Microtest.docx