1. Any patient with anginal chest pain at rest or palpitations/dysrhythmia causing cardiac decompensation (SOB, oedema) should be considered for acute admission.

2. Any patient with anginal chest pain at rest or palpitations/dysrhythmia causing cardiac decompensation (SOB, oedema) where the clinician feels that admission is inappropriate but needs urgent review should either be discussed with a consultant cardiologist or cardiac GPwSI (Matt Fay @ Westcliffe 580787 or Andreas Wolff @ Ashcroft 637076) re urgent clinic appointment. The GPwSI service can help facilitate referral in to BTHT urgently if deemed necessary but this is left to the clinician's discretion.

3. Any patient which the clinician feels needs to be in clinic soon should be referred to Cardiac Triage but also call Alison Keighley (323561) so a 'soon' appointment can be made

4. Any patient with anginal sounding chest pain of new onset should be referred to the Rapid Access Chest Pain Service (Fax 382371) irrespective of their ability to walk on a treadmill or resting ECG. Known or suspected aortic stenosis remains the only exclusion and should be referred to Cardiac Triage Service at Eccelshill (Fax 323216).

5. Any patient with a return of angina sounding chest pain after intervention and previous discharge from the hospital services should be referred to Rapid Access Chest Pain Service (Fax 382371) ) irrespective of their ability to walk on a treadmill or resting ECG. Known or suspected aortic stenosis remains the only exclusion and should be referred to Cardiac Triage Service at Eccelshill (Fax 323216).

6. Any patient with increasing angina should be referred to the Cardiac Triage Service at Eccelshill (Fax 323216) where there will be a maximum of 7 days before triage.

7. Any patient who has previously seen a cardiologist but has now been discharged should be referred to Cardiac Triage Service at Eccelshill (Fax 323216)

8. Any patient (clinician) who wishes to be seen by a specific consultant (i.e. has previously been seen by one of the cardiologists and wishes to see them again) should be referred to Cardiac Triage Service at Eccelshill (Fax 323216) but this should be made explicit in the form (you can click on a specific consultant). If this is sent directly to BTHT it will be redirected to Eccleshill and thus delay a patients review

The referrals to Cardiac Triage are seen within a maximum of 7 days (i.e. the referral comes in after one of the GPSIs have just left and thus will wait till the following week).

We have in the past, and will continue to offer, the ability of a clinician to ask for a patient to be seen in the next clinic and will always strive to be able to do this.  Any suggestions or comments are gratefully received, but could you copy in Beverley Slater (Beverley.slater@bradford.nhs.uk)