October 2025
Please see recently updated info on IMPACT nurse led service for long term illnesses including conditions they cover, contact details, referral criteria, and useful referral guidance: https://apps.nhslothian.scot/refhelp/guidelines/admissionsurgentcare/improved-anticipatory-care-and-treatment-impact/
Watch key updates from the most recent clinical review of the Scottish Referral Guidelines for Suspected Cancer on Gateway C currently covering lung & pleural, breast, brain & CNS cancers. https://apps.nhslothian.scot/refhelp/education/refbites-bitesize-learning/
Children and young people with thyrotoxicosis should be referred urgently (same day) to Paediatric Endocrinology. Please see more details on Hyperthyroidism, interpretation of thyroid tests for GPs, and referral guidelines here: https://apps.nhslothian.scot/refhelp/guidelines/paediatrics/paediatric-endocrinology-diabetes/thyroid-disorders-paediatric/hyperthyroidism-children-and-young-people/
Check out the clearly outlined referral pathway for puberty issues (both precocious and delayed) including primary & secondary signs, age criteria, and guidance on when to refer or reassure: https://apps.nhslothian.scot/refhelp/guidelines/paediatrics/paediatric-endocrinology-diabetes/puberty/
Most endocrine conditions can be safely referred for outpatient review, but certain conditions must be seen urgently, or as a same day emergency. Please see newly added Paediatric Endocrinology Guidance with detailed service info & referral guidelines. https://apps.nhslothian.scot/refhelp/guidelines/paediatrics/paediatric-endocrinology-diabetes/
New information on adrenarche including clinical significance, initial assessment, referral guidelines, and SPEG parent information leaflets. https://apps.nhslothian.scot/refhelp/guidelines/paediatrics/paediatric-endocrinology-diabetes/puberty/adrenarche/
Delayed puberty in boys – to refer or not? Please see referral guidelines on ‘Who to Refer’ : https://apps.nhslothian.scot/refhelp/guidelines/paediatrics/paediatric-endocrinology-diabetes/puberty/delayed-puberty-in-boys/
A new drop-in service is available every Friday morning at Howden Health Centre in Livingston from 8:30 AM to 11:00 AM. This is for anyone with an urgent sexual health issue. For more information on Sexual Health Locality Clinics please see here: https://apps.nhslothian.scot/refhelp/guidelines/sexualreprohealth/sexualhealthperipheralclinics/
Detailed info on initial assessment, growth charts, and referral advice for delayed puberty in girls. https://apps.nhslothian.scot/refhelp/guidelines/paediatrics/paediatric-endocrinology-diabetes/puberty/delayed-puberty-in-girls/
Precocious puberty in boys is defined as the onset of puberty before the age of 9 years. Please consider red flag symptoms, such as those of a space occupying lesion, dysmorphic features, or birthmarks. For more tips on initial assessment please see: https://apps.nhslothian.scot/refhelp/guidelines/paediatrics/paediatric-endocrinology-diabetes/puberty/precocious-puberty-in-boys/
New RefHelp page on Female Sterilisation. Please note surgery to reverse sterilisation is no longer available in NHS Lothian so the procedure should be considered fully irreversible. Full details here: https://apps.nhslothian.scot/refhelp/guidelines/sexualreprohealth/contraception/femalesterilisation/
Precocious puberty in girls is defined as the onset of puberty before the age of 8 years. Tips for initial assessment, indications for referral, and parent information leaflets available here: https://apps.nhslothian.scot/refhelp/guidelines/paediatrics/paediatric-endocrinology-diabetes/puberty/precocious-puberty-in-girls/
Potential causes of short stature in children are broad ranging, & therefore a careful history & examination are essential to narrow down the possibilities. For helpful info on possible causes, assessments, referral advice, and useful resources please see: https://apps.nhslothian.scot/refhelp/short-stature/
Contraception services are delivered in Chalmers Centre, Edinburgh. Local clinics are also available across Lothian. For services offered and referral guidelines please check: https://apps.nhslothian.scot/refhelp/guidelines/sexualreprohealth/contraception/
