HAEMATURIA PATHWAY G.P REFERRAL PROTOCOL

ALL HAEMATURIA PATIENTS TO BE ELECTRONICALLY REFERRED TO

THE UROLOGY TRIAGE OFFICE

REFERRAL CRITERIA

Patients presenting with macroscopic haematuria

·  All men with macroscopic haematuria

·  All women over 40 with macroscopic haematuria

·  All women under 40 with macroscopic haematuria and no evidence of urinary tract infection

Patients presenting with microscopic haematuria

Microscopic haematuria is identified by:

Dipstick positive or microscopy positive

(Note: At present there is no evidence base for dipstick testing for haematuria in asymptomatic patients, at routine health screening.)

Where to refer microscopic haematuria:

Urology Nephrology

Lower tract symptoms Proteinuria > + or Age > 40 Raised serum creatinine or

Hypertensive

NEPHROLOGICAL REFERRAL

Any patient presenting with haematuria who has definite signs of nephrological problems (as stated above) will be referred direct to the Nephrology service for investigation. At present nephrology referrals cannot be sent electronically.

Investigations required:

·  BP measurement

·  MSU – culture and microscopy

·  Dipstick testing for proteinuria

·  U & E

·  Identify whether patient has lower tract symptoms

·  PSA (in men over 50)

·  Urine cytology

The above investigations will be undertaken by either referring GP or Triage Office.

·  Cystoscopy – Arranged with patient by Triage Office (North Bradford PCT GP’s to remote book cystoscopy and enter date on electronic record)

Whoever receives the results of the investigations must enter them onto the SystmOne patient record.

The shared electronic record, and all information held on it, will be available to be viewed by the G.P throughout their patients’ journey.

Conclusion of pathway

·  Patients will be referred, at any stage, to either specialty if deemed appropriate

·  If at end of urological investigations there are any abnormal results – patient will be referred to Nephrology

·  If at end of urological investigation there are no abnormal results – the patient will be referred back to their own GP for annual monitoring

o  BP measurement, U & E’s, Urine microscopy

Criteria for G.P re-referral for investigation

·  Episodes of macroscopic haematuria

·  Abnormal results on monitoring

·  GP has concerns regarding patients condition