Referral to the 28 day faster diagnosis urgent Bowel Service

This patient information has been provided by Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust to help you understand your care and treatment.

A PDF version of this leaflet can be viewed here. Alternatively, the information is provided below.

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Referral to the 28 day faster diagnosis urgent Bowel Service

Your GP has given you this leaflet because you have urgently been referred into the bowel service at Doncaster and Bassetlaw teaching hospital.

What is an appointment?

Your GP believes that you may have a problem with your bowels. Bowel symptoms are very common. Most are not caused by anything serious, but we usually test for bowel cancer first.

In order to make sure you have the right test you will need to be assessed by a specialist bowel team of doctors and nurses.

To make sure that this is done as quickly as possible you will be offered a hospital appointment or a telephone consultation for this assessment and all tests and results should be available within 28 days of your doctor’s referral.

I do not think I have a problem with my bowels, why has my doctor referred me?

Bowel problems can often result in obvious symptoms such as bleeding from the bottom or with diarrhoea or constipation. However, sometimes bowel problems can cause less obvious symptoms, such as weight loss, abdominal pain or unexplained lumps in your tummy or bottom.

Abnormal blood tests that show anaemia or low levels of haemoglobin (the stuff that carries oxygen around in the blood) may also be related to problems with the bowel.

In many cases your GPs are now being asked to perform a test on your poo known as a FIT test before you are referred. This looks for microscopic traces of blood within the bowel.

If the test is negative it is extremely unlikely that there is any serious bowel problem. If the test is positive then it means that a problem is more likely, but most people with a positive test will still not have anything worrying in the bowel.

What happens next?

Once we receive your referral, we aim to contact you by telephone the next working day to plan a suitable time for your appointment.

There are two types of appointment:

  • Telephone appointment: If your symptoms are straight forward and you are in reasonable health, then we can usually assess you by a 15-20 minute telephone consultation. The advantage of this is that you are not required to attend the hospital and we can normally ring you within a few days of your referral. This ensures that any further tests are done as quickly as possible and we would normally try to arrange these within 2 weeks of your referral.

  • Clinic appointment: If we are not able to reach you by phone or if the information from your GP suggests that it would be better to meet with you before arranging tests, then we will make a clinic appointment for you to see a specialist face to face. There are a number of different tests that can be used to examine the bowel, some of which require special preparation and so it is important that we chose the right test for you. We would aim to make clinic appointments within 1-2 weeks of your referral and carry out tests within 2-3 weeks of your referral.

In order to arrange the appointment for you as quickly as possible, it is very important that we have the right telephone number for you. Your GP will provide us with the phone number they have on record for you.

If you think this information may not be correct or if you have a different preferred contact number, then you can get in touch with us on: 01302 644680. Please also ensure that your GP records are updated. If we cannot contact you by phone after 2 attempts or you are unable to receive phone calls, then we will send you a hospital clinic appointment by post.

What tests am I likely to need following the assessment appointment?

Not all patients referred undergo further tests on their bowel, but most do. The most common tests used are:

  • Colonoscopy. A thin flexible telescope with a tiny camera on the end is inserted into your bottom and carefully steered around your large bowel to directly examine the lining. Samples can be taken from your bowel to be looked at under the microscope (biopsy). The day before this test you will need to take some strong laxative medication to empty your bowels so that clear views can be seen.

  • CT scan. A body scan is taken of you whilst lying down using an x-ray machine. This shows your other internal organs as well as your bowel, but doesn’t show up the lining of your bowel as well as the colonoscopy.

  • CT colonography. This is a special type of CT scan which gives better pictures of your bowel. You will need to drink some x-ray dye before hand to show up the inside of your bowel and some air will be pumped around your bowel during the test.

What if I choose not to have the recommended tests?

The assessment appointment will give you the opportunity to discuss what tests may be necessary and why these might be important. At the end of the day you are free to choose whether or not you have the tests recommended. If you are considering not proceeding with these tests, then you should let us know as soon as possible so that these valuable appointments can be used for someone else.

What happens after I have had my tests?

In some cases, we will be able to tell you there and then what we think has been causing your symptoms and offer you treatment straight away or refer you on for treatment. In other cases it can take several days for the tests to be reviewed by a specialist. We will contact you in writing with the results of tests or arrange a further appointment to discuss these in more detail.

What if the tests do not identify a problem and I am still having problems with my bowels?

The 28 day faster diagnosis standard service is largely designed to detect or exclude the presence of cancer in the bowels as quickly as possible, though many other bowel problems can also be detected. If nothing of concern is identified on the tests, then your GP should be able to help you with your trouble and we would recommend that you make a further appointment to discuss your problems.

Patient Advice & Liaison Service (PALS)

The team are available to help with any concerns, complaints or questions you may have about your experience at the Trust. Their office is in the Main Foyer (Gate 4) of Doncaster Royal Infirmary. Contact can be made either in person, by telephone or email.

The contact details are:
Telephone: 01302 642764 or 0800 028 8059
Email: dbth.pals.dbh@nhs.net

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