There is guidance on this page for assessment and, where appropriate, referral for Abdominal Hernia. Please see the link above for information on assessment for Groin Hernia.
ASA Categories and Frailty Assessment
The flowcharts above refer to ASA Categories. These are used to provide general information regarding a patient’s fitness to undergo an anaesthetic based on the patient’s comorbidities that are known to the GP.
The GP is not being asked to undertake an anaesthetic assessment. All patients who are to have surgery will go through the appropriate pre-operative assessment in secondary care, including attendance at pre-operative clinic and anaesthetic assessment where appropriate.
More information on ASA categories can be found here and there are further resources under Resources and Links to tools that GPs may find helpful when discussing with a patient their fitness for surgery. In some situations the ASA category will not be clear and this can be outlined in the referral text.
For Frailty assessment of patients over the age of 65 then it is recommended that referrers use the Rockwood Frailty score. A summary of this is available in the Resources and Links section.
J.B & R.M – 12-06-26
Who can refer
GPs and ANPs working in Primary Care
Who to refer
As per the flowchart above
Who not to refer via these pathways
Patients with symptoms of obstruction or a strangulated hernia – these patients should have an emergency same day referral to secondary care
Patients with other types of hernia not covered by the pathway above – these patients should be referred to General Surgery via a Basic Sign Referral
How to refer
Please refer via SCI Gateway.
Please follow the flowchart above for which site patients can be referred to.
For RIE and SJH referrals the referral pathway is:
- RIE >> GENERAL SURGERY >> LI BASIC SIGN REFERRAL
OR
- SJH >> GENERAL SURGERY >> LI BASIC SIGN REFERRAL
Where referral to the WGH is appropriate the referral pathway is:
- WGH >> GENERAL SURGERY – COLORECTAL >> LI BASIC COLORECTAL REFERRAL
