Oxford University Hospitals NHS Foundation Trust
Bone Infection

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Referrals - information for clinicians only

We can only accept doctor-to-doctor referrals made in writing. Referrals can be sent to the Consultant in Infectious Diseases (ID) at the Bone Infection Unit or to a named surgeon at the Nuffield Orthopaedic Centre. Regardless of whoever receives the referral, the whole team will be usually be involved.

A strict appointment system operates, and referrals are prioritised on clinical need based on the information supplied by the referring medical practitioner.

Exclusions

  1. Please note we cannot take acutely septic/unwell patients from other trusts. If a patient needs an urgent procedure to decompress pus/abscess this should be done locally.
  2. Please note that uncomplicated cellulitis is managed via the general Infectious Diseases Unit at the Churchill Hospital.
  3. There is an alternative service for children under 16 years – please see below.
  4. Head and neck osteomyelitis should be first discussed with one of the BIU consultant physicians directly before referral to this centre (or if an in-patient in the OUH - referred to the relevant ID/micro consult service).
  5. We do not accept referrals exclusively and specifically for the administration of OPAT / Home IV therapy. Such requests should be discussed with one of the ID consultants by telephone (or if an in-patient in the OUH - referred to the relevant ID/micro consult service).

Suggested investigations

  • Patient should attend with the results of the following done within two weeks of their appointment date: FBC, U&E, LFT, CRP.
  • Plain X-ray is generally the minimum requirement for all referrals, (except spinal infection where it may not be useful).
  • X-rays / MRI imaging must accompany referral in digital form. Please arrange for your PACS team to transfer them to the IEP server. Preferred format: DICOM.

Administration requirements

  1. Send a referral letter to the Bone Infection Unit consultant by post or email. This should include an indication of the clinical complexity, including presenting problem, past medical and surgical history, antibiotic exposure and allergies, MRSA or other multi-resistant organism status and current medication including antibiotics. This is essential to allow us to allocate the appropriate Infectious Disease Consultant, Orthopaedic Consultant and, if relevant, Plastic Surgery Consultant to your patient.
  2. Please ensure demographic details for the patient are up-to-date and complete, and include a contact telephone number for the patient. See our referral proforma (MS Word document) for guidance on the information that needs to be included.
  3. State if an interpreter is required including language/dialect.
  4. Please ensure all imaging has been transferred to the IEP server. To do this contact your local PACS team. Where possible please obtain the transaction code and include this within your referral. We are unable to progress without imaging as all patients are discussed within our MDT meeting.
  5. Transport (if applicable) to our Trust must be booked by the GP once appointment confirmed.
  6. Your patient will be seen by a member of our team, including doctors in training, who will discuss the case with a consultant. All new patients will be reviewed by a consultant.
  7. Appropriate investigations and follow-up will be arranged at your patient's clinic visit.
  8. Admission to the Bone Infection Unit from outpatients will only occur if your patient requires emergency surgery.
  9. All letters from our clinic are sent to your patients GP and/or the referring surgeon/physician.
  10. Correspondence will be copied to the patient unless they opt not to receive correspondence.

Alternative services

Please contact the Bone Infection Unit on 01865 737878 if you wish to refer children under the age of 16 years with bone and joint infection.

Booking details

Please note that all referrals for each service are reviewed by the relevant clinicians prior to the clinic, and this may result in a patient appointment being re-assigned to any of the consultants for the specialty, or a member of their teams, to ensure that the most appropriate clinical treatment is provided.