One Stop Clinics

Key features:

Fewer hospital visits
Initial consultation plus one (or more) tests on the same day

Any medically stable adult (18-80) patient with no significant co-morbidity, able to fast before attending the consultation and having the test(s) on the same day as a Day Case, is suitable for One Stop Clinics.


Accepted indications:

Un-investigated or part investigated dyspepsia (upper abdominal discomfort)
Abnormal liver function tests (LFTs)


Diagnostic tests offered in the One Stop Clinic:

1. Upper gastrointestinal endoscopy (OGD)
2. Abdominal ultrasound scan for dyspepsia or abnormal LFTs
3. Radiological investigations such as chest/abdominal x-ray, CT or MRI
4. Appropriate haematological and biochemical blood tests


Background

One Stop Service provides a consultation, followed by radiology and/or endoscopy tests on the same day, to save the patient multiple visits to the hospital to have separate procedure(s). It may be possible in selected cases to extend this to a co-ordinated multi-disciplinary outpatient consultation service on the same day.


One Stop Dyspepsia and Liver Clinics

Many endoscopy units or gastroenterologists in the UK offer an Open Access Endoscopy and Jaundice Clinic service to general practitioners. However, for patients with dyspepsia, endoscopy is not always the most appropriate initial investigation, and the One Stop Dyspepsia clinic allows for different approaches. The conventional Jaundice Clinic doesn’t cater for patients with abnormal liver function tests but are not jaundiced. Many of these patients would also benefit from rapid access one stop outpatient assessment.


How to book

The patient may be referred by his/her GP or another medical specialist. Any patient who needs a specific endoscopy test but not requiring a consultation may be suitable for Direct Access Endoscopy.

Call Michelle Huxley on 01926 436 342 or email michelle.huxley@nuffieldhealth.com to discuss your patient’s requirements.


Rapid access to a specialist assessment


Following the referral, the patient will get an appointment to be seen and have the appropriate test done urgently. Most patients will be seen within 2 weeks. My secretary will contact the patient (usually by phone), to advise on the preparation required prior to attending the clinic.

Prior to the diagnostic investigation (on the same day), the patient is seen in the outpatient clinic for discussion and planning of management.

It is a prerequisite that any patient requiring an endoscopy test is informed of the risks, benefits, and alternatives. Please advise the patient to review the linked pages:


Endoscopy test information



One Stop Clinics are not appropriate for any patient who:

needs an urgent consultation but the key investigation to provide the diagnosis is not immediately obvious. Such patients should be referred to be seen URGENTLY in the outpatient clinic.
is frail, very elderly or with significant co-morbidity therefore unable to cope with having the consultation and the test on the same day as an outpatient.
requires advanced diagnostic or therapeutic endoscopy such as ERCP or EUS.

 
Please note:

The service is currently available for private referrals only.
The patient may undergo the radiology and/or endoscopy procedure by a specialist or gastroenterologist different from the initial consultation.
The service may be available on specific days only and by prior arrangement, at least one week in advance.


Follow up

The patient is normally offered one follow up outpatient appointment or treatment where indicated. The radiology or endoscopy reports will be faxed or sent by mail promptly. The results of tissue sample analysis with management recommendations will be sent as quickly as feasible.

If an abnormality (e.g. a cancer) is found, arrangements are made immediately for further investigations and follow up.