{"id":4151,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/moewestlothian\/"},"modified":"2026-05-15T14:44:07","modified_gmt":"2026-05-15T13:44:07","slug":"moewestlothian","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/moewestlothian\/","title":{"rendered":"MoE West Lothian"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Current services for Medicine for the Elderly in West Lothian <\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>SCI gateway single point of contact referral for non-urgent <\/li>\n\n\n\n<li>REACT for urgent 01506 523173<\/li>\n\n\n\n<li>Referral should be based on patient&#8217;s postcode, <strong>not<\/strong> GP Practice <\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong>REACT Hospital at Home (H@H)<\/strong><\/td><td>Acutely unwell frail, older peopleAlternative to hospital admissionShort term (few days)Comprehensive geriatric assessment at home (inc care home) in the acutely decompensated<\/td><td>Phone call to REACT hub 01506 523173 if urgent (same day\/next day) visit required \u2013 clinical conversation is usefulNot an alternative to a GP visit.SCI gateway referral if able to wait 2-3 days for assessment.<\/td><\/tr><tr><td><strong>REACT Rapid Access Clinic<\/strong><\/td><td>We triage to home visits, face to face clinic, and phone\/video as appropriate. Please make clear if patient could physically come to clinic.We will refer to AHPs if needed<\/td><td>SCI gateway referralSt Johns Hospital &gt; REACT&nbsp;We aim to see within 2 weeks. &nbsp;<\/td><\/tr><tr><td><strong>Parkinson`s Disease clinic<\/strong>(see&nbsp;<a href=\"\/refhelp\/guidelines\/Parkinsons-(MoE)\" target=\"_blank\" rel=\"noreferrer noopener\">Parkinsons<\/a>&nbsp;RefHelp guidance)<\/td><td>PD patientsNew patients with ?PD \/ tremor etc.We triage to home visits, face to face clinic, and phone\/video as appropriate.<\/td><td>SCI gateway referralSt Johns Hospital &gt; Geriatric Medicine&nbsp;<\/td><\/tr><tr><td><strong>Osteoporosis clinic<\/strong>(see&nbsp;<a href=\"\/refhelp\/guidelines\/Osteoporosis\" target=\"_blank\" rel=\"noreferrer noopener\">Osteoporosis<\/a>&nbsp;RefHelp guidance)<\/td><td>No longer based in West Lothian<\/td><td>SCI gateway<strong>*All referrals now to Edinburgh rheumatology service*<\/strong><\/td><\/tr><tr><td><strong>General MOE clinic<\/strong><\/td><td>We triage to home visits, face to face clinic, and phone\/video as appropriate.<\/td><td>SCI gateway referralSt Johns Hospital &gt; Geriatric Medicine<\/td><\/tr><tr><td><strong>Stroke\/TIA clinic<\/strong>(see&nbsp;<a href=\"\/refhelp\/guidelines\/TransientIschaemicAttackTIAAndStroke\" target=\"_blank\" rel=\"noreferrer noopener\">TIA&nbsp;And&nbsp;Stroke<\/a>&nbsp;RefHelp guidance)<\/td><td>&nbsp;<\/td><td>Centralised stroke\/ TIA hotline available for GPs to obtain immediate\u00a0 advice and appointments organised- please see the RefHelp page <a href=\"\/refhelp\/guidelines\/TransientIschaemicAttackTIAAndStroke\" target=\"_blank\" rel=\"noreferrer noopener\">TIA\u00a0And\u00a0Stroke<\/a>\u00a0<br>In Hours: For Stroke\/TIA Hotline contact please see:\u00a0<a href=\"http:\/\/intranet.lothian.scot.nhs.uk\/Directory\/RefHelp\/SecureContent\/Pages\/default.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">Secure intranet page<\/a><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td><strong>St Michael&#8217;s Hospital<\/strong><strong>Linlithgow<\/strong><strong>Tippethill House Hospital, Armadale<\/strong><\/td><td>Hospital Based Complex Clinical Care (HBCCC)Palliative care for West Lothian patients.&nbsp;<strong>*Please refer to community hospitals&nbsp;<a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Pathway-for-referrals-to-community-hospitals-Oct-2020.pdf\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Pathway-for-referrals-to-community-hospitals-Oct-2020.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Pathway for referrals to community hospitals<\/a>\/ inclusion criteria<\/strong>&nbsp;(Please discuss with patient \/ family. Clear anticipatory planning \/ escalation of care conversation needed before referral.Patient not for transfer to acute sector for diagnostics\/interventionNot requiring daily specialist consultant palliative care input)<\/td><td>&nbsp;Weekdays 9am-6pmIf community hospital admission required, please refer to REACT 01506 524149 stating that assessment required for admission.REACT will assess if appropriate. &nbsp;<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li>Frail older people in need of secondary care assessment<\/li>\n\n\n\n<li>Single point of contact \u2013 SCI referral for all but urgent (triaged daily)<\/li>\n\n\n\n<li>Same day \/ next day urgent assessment should be via REACT H@H and discussed with REACT coordinator (i.e. referral is to avoid hospital admission)<\/li>\n\n\n\n<li>Geriatrician is available for advice via above<\/li>\n\n\n\n<li>Please include question to be answered and if possible&nbsp;<a href=\"\/files\/sites\/2\/rockwood_cfs.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">rockwood_cfs<\/a>&nbsp;clinical&nbsp;frailty score (or equivalent assessment of frailty) as this helps us to triage to correct service.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Appropriate referrals for REACT\/rapid access\/general MOE clinic (equivalent) assessment (excl stroke and PD):<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Falls, frailty syndromes including dizziness<\/li>\n\n\n\n<li>Weight loss in frail older patients<\/li>\n\n\n\n<li>Multiple\/complex symptoms in frail<\/li>\n\n\n\n<li>Single symptom suggestive of malignancy if frail (consider if single organ specialty referral more appropriate especially if clinical frailty score &lt;4)<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Weight loss in non-frail patients (ie clinical frailty score &lt;4) \u2013 should be referred to General Medicine in West Lothian<\/li>\n\n\n\n<li>Iron deficiency anaemia (single issue) \u2013 should be referred to GI in West Lothian<\/li>\n\n\n\n<li>Memory loss only \u2013 should be referred to Memory Clinic \/ Old Age Psychiatry in West Lothian<\/li>\n\n\n\n<li>Polypharmacy reviews \u2013 Integrated Care Pharmacists in GPs can help with this<\/li>\n\n\n\n<li>Incontinence \u2013 consider continence nurse \/ DN referral<\/li>\n\n\n\n<li>End of life support &#8211; palliative care team (REACT if considering admission to community hospital)<\/li>\n\n\n\n<li>Care home support \u2013 West Lothian Care Home Liaison Team, WelPAT.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>ALL the above do not preclude the referral being appropriate \u2013 clinical judgment is required. We are more than happy to discuss referrals\/give advice.&nbsp;<\/strong><\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\"><strong>Primary Care Management \/ Pre-referral work-up \/ Information needed<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Please see also specific guidance for each condition;&nbsp;<a href=\"\/refhelp\/guidelines\/Falls\" target=\"_blank\" rel=\"noreferrer noopener\">Falls<\/a>,&nbsp;<a href=\"\/refhelp\/guidelines\/WeightLoss\" target=\"_blank\" rel=\"noreferrer noopener\">Weight&nbsp;Loss<\/a>,&nbsp;<a href=\"\/refhelp\/guidelines\/Dizziness\" target=\"_blank\" rel=\"noreferrer noopener\">Dizziness.aspx<\/a>,&nbsp;<a href=\"\/refhelp\/guidelines\/Delirium\" target=\"_blank\" rel=\"noreferrer noopener\">Delirium<\/a>,&nbsp;<a href=\"\/refhelp\/guidelines\/Parkinsons-(MoE)\" target=\"_blank\" rel=\"noreferrer noopener\">Parkinsons<\/a>&nbsp;disease<\/li>\n\n\n\n<li>Bloods \u2013 FBC, U&amp;E, LFTs, calcium, TFTs, B12\/folate +\/- iron studies and ferritin for all clinic referrals.<\/li>\n\n\n\n<li>E&amp;S BPs if referring for&nbsp;<a href=\"\/refhelp\/guidelines\/Falls\" target=\"_blank\" rel=\"noreferrer noopener\">Falls<\/a><\/li>\n\n\n\n<li>Meds have been reviewed (at least initially)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Information needed:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Some indication of frailty \u2013 functional status\/baseline and POC\/family support is most helpful. Clinical frailty score also helpful.<\/li>\n\n\n\n<li>What is the aim of referral and what are the patient and family&#8217;s expectations. (i.e. if frail patient not for investigations of possible malignancy \u2013 what is it that is hoped the referral will achieve?)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Alternatives to referral \/ advice<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Email and\/or phone advice always available<\/li>\n\n\n\n<li>Telephone via REACT \u2013 coordinator initially \u2013 ask for consultant geriatrician if needed&nbsp;<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Pathway-for-referrals-to-community-hospitals-Oct-2020.pdf\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Pathway-for-referrals-to-community-hospitals-Oct-2020.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Pathway for referrals to community hospitals<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Frailty_Information_Resource.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Frailty Information Resource<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/FRAILTY-POSTER.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Frailty Poster <\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/services.nhslothian.scot\/futurecareplanning\/care-homes\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/services.nhslothian.scot\/carehomes\/services-anticipatory-care-planning<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Current services for Medicine for the Elderly in West Lothian REACT Hospital at Home (H@H) Acutely unwell frail, older peopleAlternative to hospital admissionShort term (few days)Comprehensive geriatric assessment at home (inc care home) in the acutely decompensated Phone call to REACT hub 01506 523173 if urgent (same day\/next day) visit required &ndash; clinical conversation is<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3664,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[311],"class_list":["post-4151","page","type-page","status-publish","hentry","category-moe-west-lothian"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/medicineofelderlygeriatrics\/medicine-of-the-elderly-services\/moe-west-lothian\/\" rel=\"tag\">MoE West Lothian<\/a>","rttpg_excerpt":"Current services for Medicine for the Elderly in West Lothian REACT Hospital at Home (H@H) Acutely unwell frail, older peopleAlternative to hospital admissionShort term (few days)Comprehensive geriatric assessment at home (inc care home) in the acutely decompensated Phone call to REACT hub 01506 523173 if urgent (same day\/next day) visit required &ndash; clinical conversation is","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4151","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4151"}],"version-history":[{"count":16,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4151\/revisions"}],"predecessor-version":[{"id":27967,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4151\/revisions\/27967"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3664"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4151"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4151"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}