{"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":"2026-06-12T14:52:50","modified_gmt":"2026-06-12T13:52:50","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><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/admissionsurgentcare\/hospital-at-home\/hh-west-lothian-2\/\" target=\"_blank\" rel=\"noreferrer noopener\">Hospital at Home<\/a> for urgent medical\/nursing input 01506 523173<\/li>\n\n\n\n<li>Referral should be based on patient\u2019s postcode, <strong>not<\/strong> GP Practice<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-table aligncenter\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>Hospital at Home (H@H)<\/strong><\/td><td>Acutely unwell frail, older people<br>Alternative to hospital admission<br>Short term (few days)<br>Comprehensive geriatric assessment at home (inc care home) in the acutely decompensated &nbsp;<\/td><td>Phone call to H@H hub 01506 523173 or mobile 07811710633 if urgent (same day\/next day) visit required \u2013 clinical conversation is useful. <br>Not an alternative to a GP visit. &nbsp;<\/td><\/tr><tr><td><strong>&nbsp;<\/strong> <strong>AHP<\/strong><\/td><td>AHPs only \u2013 physio and OT <br>Full assessment at home \u00a0<\/td><td>Through the IAP (Integrated Access Point): <br><br><strong>Urgent Hospital admission avoidance<\/strong>: Phone 01506 523124 or Email: <a href=\"mailto:loth.wlcommunityspoc@nhs.scot\" target=\"_blank\" rel=\"noreferrer noopener\">loth.wlcommunityspoc@nhs.scot<\/a><br><br><strong>Routine Referrals<\/strong>:\u00a0 referral via SCI gateway referral <br>St John\u2019s Hospital &gt; Geriatric Medicine &gt; LI Rapid Elderly Assess -REACT \u00a0<\/td><\/tr><tr><td><strong>Rapid Access Clinic<\/strong><\/td><td>We triage to home visits or face to face clinic as appropriate. Please make clear if patient could physically come to clinic. <br>We will refer to AHPs if needed &nbsp;<\/td><td>SCI gateway referral St John\u2019s Hospital &gt; Geriatric Medicine &gt; LI Rapid Elderly Assess -REACT \u00a0 <br><br>We aim to see as soon as possible\u00a0<\/td><\/tr><tr><td><strong>Parkinson&#8217;s Disease clinic<\/strong> (see <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/medicineoftheelderlygeriatrics\/parkinsons-moe\/\" target=\"_blank\" rel=\"noreferrer noopener\">Parkinson\u2019s RefHelp<\/a> guidance)<\/td><td>PD patients <br>New patients with ?PD \/ tremor etc.<br>We triage to home visits or clinic, as appropriate &nbsp;<\/td><td>SCI gateway referral <br>St John\u2019s Hospital &gt; Geriatric Medicine &gt; LI WL Geriatric Medicine \u00a0 <br><br>Young onset Parkinsons, tremor without any other Parkinsonian features should be referred to Neurology<\/td><\/tr><tr><td><strong>Osteoporosis clinic<\/strong> (see <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/rheumatology-2\/osteoporosis\/\" target=\"_blank\" rel=\"noreferrer noopener\">Osteoporosis RefHelp<\/a> guidance) &nbsp;<\/td><td>No longer based in West Lothian<\/td><td>&nbsp; <strong>*All referrals now to <\/strong><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/rheumatology-2\/osteoporosis\/\" target=\"_blank\" rel=\"noreferrer noopener\">Edinburgh rheumatology service<\/a><strong>*<\/strong> &nbsp;<\/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 &nbsp;<\/td><td>SCI gateway referral <br>St John\u2019s Hospital &gt; Geriatric Medicine &gt; LI WL Geriatric Medicine &nbsp;<\/td><\/tr><tr><td><strong>Stroke\/TIA clinic<\/strong> (see <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/neurology\/transientischaemicattacktiaandstroke\/\" data-type=\"page\" data-id=\"4480\" target=\"_blank\" rel=\"noreferrer noopener\">Stroke RefHelp<\/a> guidance)<\/td><td>&nbsp;<\/td><td>Centralised stroke\/ TIA hotline available for GPs to obtain immediate advice and appointments organised- please see the RefHelp page <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/neurology\/transientischaemicattacktiaandstroke\/\" target=\"_blank\" rel=\"noreferrer noopener\">Transient Ischaemic Attack (TIA) And Stroke<\/a> <br><br>In Hours: For Stroke\/TIA Hotline contact please see:&nbsp;<a href=\"http:\/\/intranet.lothian.scot.nhs.uk\/Directory\/RefHelp\/SecureContent\/Pages\/default.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">Secure Content<\/a> &nbsp;<\/td><\/tr><tr><td><strong>Tippethill House Hospital, Armadale<\/strong><\/td><td>Hospital Based Complex Clinical Care (HBCCC) Palliative care for West Lothian patients. &nbsp; <br><br><strong>*Please refer to community hospitals pathway first for exclusion \/ inclusion criteria.*<\/strong> <strong>&nbsp;<\/strong><\/td><td>If community hospital admission required, please refer to <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/admissionsurgentcare\/hospital-at-home\/hh-west-lothian-2\/\" target=\"_blank\" rel=\"noreferrer noopener\">Hospital at Home<\/a> 01506 523173. <br>We will assess if appropriate. &nbsp; <br><br>Clear anticipatory care planning and treatment escalation plan discussion with patient and family needed before referral, especially regarding appropriateness of diagnostics\/intervention and transfer to acute site.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>L.M &amp; J.B &#8211; 12-06-26<\/strong><\/p>\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 except urgent (triaged daily)<\/li>\n\n\n\n<li>Same day \/ next day urgent assessment should be via <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/admissionsurgentcare\/hospital-at-home\/hh-west-lothian-2\/\" target=\"_blank\" rel=\"noreferrer noopener\">H@H<\/a> and discussed with H@H 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 clinical 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 rapid access\/general MOE clinic 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<p class=\"wp-block-paragraph\"><\/p>\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 (i.e. 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 Bladder and Bowel Service (BABS) \/ DN referral<\/li>\n\n\n\n<li>End of life support &#8211; palliative care team (H@H if considering admission to community hospital)<\/li>\n\n\n\n<li>Care home support \u2013 DN team leads via IAP, WelPAT.<\/li>\n\n\n\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.<\/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; falls, weight loss, dizziness, delirium, Parkinsons 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 falls<\/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\u2019s expectations. If frail patient not fit 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>Telephone via H@H \u2013 coordinator initially \u2013 ask for consultant geriatrician if needed<\/li>\n\n\n\n<li>Email and\/or phone advice always available<\/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 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 &nbsp; Phone call to H@H hub 01506 523173 or mobile 07811710633 if urgent (same day\/next day) visit required &ndash;<\/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\/https-apps-nhslothian-scot-refhelp-medicine-of-the-elderly-local-services\/moe-west-lothian\/\" rel=\"tag\">MoE West Lothian<\/a>","rttpg_excerpt":"Current services for Medicine for the Elderly in West Lothian 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 &nbsp; Phone call to H@H hub 01506 523173 or mobile 07811710633 if urgent (same day\/next day) visit required &ndash;","_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":19,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4151\/revisions"}],"predecessor-version":[{"id":28342,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4151\/revisions\/28342"}],"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}]}}