2WW Please refer as usual. Referrals will be vetted on a case by case basis and managed appropriately.

• Qfit is essential as it is being used as per NICE to triage patients to the most appropriate investigation.

• CT and colonoscopy services are now running close to normal capacity.

All referrals will be reviewed prior to the allocation of appointment. The Colorectal team will continue providing clinical review for urgent cases. Again, these will be prioritised on a case by case basis.

Patients will usually be telephoned and appropriate investigations arranged. If necessary, they can be seen face-to-face.

Please ensure that a practice-based system is in place to check daily for returning referrals with A&G.

All new routine referrals will be clinically triaged and will either be added to a waiting list or, if appropriate, A&G will be given.

Please ensure that a practice-based system is in place to check daily for returning referrals with A&G.

In order to support secondary care to see the patients who need to be seen, please could we ask you to put as much detail in your referral letter as possible and clearly mark whether this referral is urgent or routine.

Prior to making a routine referral, please ensure that any appropriate Policy or CRG has been reviewed and that all the suggested investigations and management options have been considered.

Existing new and follow-up routine appointments have been cancelled and changed to telephone / video consultation where appropriate.

Urgent Colorectal advice can be sought by contacting the secretary to the consultant colorectal surgeon (on-call, on hot week) or by contacting the on-call surgical Registrar via Switchboard:

"For urgent colorectal advice ONLY, please send your queries to the following email address: email: ndht.colorectal@nhs.net, this is reviewed every weekday. Out of hours please contact the on call surgical team as clinically indicated. "

Northern Devon Healthcare NHS Trust telephone: 01271 322577

Advice and Guidance will continue to be given by letter; we are looking to develop A&G through referrals via e-RS.

Please ensure that a practice-based system is in place to check daily for returning A&G.

"For urgent colorectal advice ONLY, please send your queries to the following email address: email: ndht.colorectal@nhs.net, this is reviewed every weekday. Out of hours please contact the on call surgical team as clinically indicated. "

All colorectal referrals in the presence of symptoms of COVID-19 should be discussed with the admitting team who will assess along hospital guidelines.

High risk patients will be contacted via letter regarding steps they need to take to protect themselves during the pandemic.

Patient information

• MyHealth-Devon: Haemorrhoids

Pathway Group

This guideline has been signed off on behalf of the NHS Devon Clinical Commissioning Group

Publication date: Mach 2020