Patient referral

Your GP will refer you into the Orthopaedic Department through a system called the SCI Gateway. This system allows your GP to send a referral letter electronically directly to us.

When you attend your GP please give them details of all unavailability and if you would require an interpreter to be in attendance at your appointment.

Please ensure that all contact information is up to date.

You may be referred into Orthopaedics following an attendance at Accident and Emergency. If you have had an injury and follow up has been recommended within the Orthopaedic Department, the A&E staff will advise you that you will receive a phone call within the next 72 hours from a member of the Orthopaedic Team. This is called the Virtual Fracture Clinic.

Vetted referral

This means your referral letter will be looked at by a Clinician or a member of the multi-disciplinary team in the Orthopaedic Department, after which a decision will be made about the appropriate clinic for you to be seen at.

The decision made will depend on the information given within the referral about the condition you have been diagnosed with. You may be offered a consultation with a member of the orthopaedic clinical team. This appointment may be with a Consultant, Nurse, Physiotherapist, Plaster Technician or other member of the multidisciplinary team. These consultations may be face-to-face, by telephone or by video consultation at your home. Information about the type of appointment offered will be detailed within your appointment letter.

Some patients will be managed through an Active Clinical Referral Triage (ACRT) pathway. For specific diagnoses, patients will be sent information explaining the condition and treatment options. If after consideration the patient wishes to discuss a surgical solution, then the ACRT letter will detail how the patient can make an appointment to speak to the orthopaedic team.

On a few occasions, it might be that an appointment is not required. This may be due to further information being required from the referrer or where it is felt that the orthopaedic service is not required. A letter explaining this will be sent to the referrer.

Active clinical referral triage referrals

In NHS Fife we offer something called Active Clinical Referral Triage or ACRT for short. We offer this for the following conditions:

  • Base of Thumb arthritis
  • Carpal Tunnel
  • Cubital tunnel syndrome
  • Dupytren’s Disease
  • Big Toe (bunion and arthritis)
  • Greater Trochanter Pain of the Hip
  • Knee meniscal cartilage injuries
  • Osteoarthritis of the hip
  • Osteoarthritis of the knee
  • Tennis elbow
  • Trigger finger
  • Ganglion cyst of the hand/wrist

ACRT is the process where you have a referral to orthopaedics from your GP or other healthcare professional. The first stage in this process is that you will be sent a relevant leaflet about your suspected condition i.e. Carpal Tunnel syndrome. The leaflet on Carpal Tunnel syndrome will inform you about this condition and how to manage it, for example with exercises and self care. It might be that after reading the information and following the exercises that you no longer wish to make further use of the Orthopaedic service and in this case we will have helped you self manage your condition. If on the other hand you would like to be added to the Waiting List for an appointment, details are provided on the information leaflet on how to do this. The ACRT process therefore helps us share the decision making about your treatment with you.