Criteria for Referral

If clinical concerns but doesn't appear to fit criteria, consider using A&G through ERS.

Patients with suspected metastatic malignancy on diagnostic imaging with undefined primary and no red flag symptoms or signs to direct to a site specific clinic except:

  • Patients with solitary neck lymph nodes should be referred to the Head & Neck 2ww clinic
  • Female patients with solitary axillary nodes should be referred to the Breast 2ww clinic
  • Male patients with sclerotic bone metastases should have a DRE and a PSA prior to referral and if raised referred to Urology 2ww clinic.

Those with vague symptoms suggestive of cancer, but with no imaging suggesting cancer, should be investigated as per the Vague Symptoms Pathway in Primary Care.

When referring, please identify the imaging confirming metastases, and where and when this was performed.

Referral Information

Please ensure the referral includes:

  • Performance Status
  • Medication (including if they have been advised to take aspirin which they buy off prescription.)

**Please arrange bloods as stated on 2WW form so they are available on ICE for first appointment.

**Advise the patient that the referral will be reviewed by a clinical member of the team and a decision made on the next steps which will usually be going directly for another test or coming to the clinic for a f2f appointment. They will be contacted by an administrative member of the team to explain these next steps.

**CRH - Advise the patient that their first appointment will be in the NGS Macmillan unit (which can be accessed directly through its dedicated entrance round the back of the hospital adjacent to car park 7a) and that this does not mean that they have cancer; just that it has been suspected on imaging. UHDB patients attending will be seen in spec/med OP.

Referrers to Derby Hospital can contact the CUP CNSs for advice. 
They are available for advice 9am-4pm, Monday - Friday, on the following numbers;
Office: 01332 786557
Beccy Warren: 07500 976513
Michael McCready: 07769 164113

Referrers to Burton Hospital can contact the team for advice.
They are available 9am – 5pm Monday – Friday on the following number:  
01283 593108 (voicemail)
Joanne Harper ANP
Melanie Bowling ANP
Karen Collins Trainee ACP
They also do AOS and can be contacted via email:
burton.aos@nhs.net.