A working reference for foundation doctors and clinicians at Pennygate Practice: phone numbers, referral routes, criteria, forms, and step-by-steps for the systems and services you use daily. The search bar at the top indexes the full text of every page — use it for specifics. This page is a map of what actually lives where, so you know which page to open.
New to the practice? Start with Clinical Supervision and Smartcards. For “how do I do X in SystmOne, Docman, or Lexacomm”, see Software Guides or the Systems & daily admin section below.
Clinical guidelines
Condition pathways, community teams, and the prescribing/certification questions that come up every surgery.
Conditions & pathways
- ADHD & ASD Referrals — Current waiting times (Wigan ADHD 7+ yr, ASD 5+ yr; RTC 3+ yr); assessments paused until March 2027; approved provider lists split by child/adult, plus Wigan team contacts.
- Someone Is Pregnant — What Next? — New-pregnancy checklist (folic acid, first midwife appointment) and maternity contacts by gestation: Leigh Unit 01942 778 628 (0–16 wk), Swinley Ward (16–18 wk), Maternity Triage via switchboard (18+ wk).
- Wigan Gynaecology Pathway — From 1 Oct 2025 routine/urgent gynae (HMB, pelvic pain, PCOS, HRT, LARC, prolapse) routes to PCN gynae (~4-week wait vs ~1-year secondary care); cancer red flags and sub-fertility excluded.
- Newly Diagnosed Diabetics — Workflow for new T2DM: AccuRx “New Diabetic DESMOND self referral” template to auto-code for QoF; DESMOND programme at Pennygate from 12 Feb 2026.
- Targeted Lung Health Check — Screening for ages 55–74 smokers; booking 0161 529 0900; exclusion criteria; suspected cancers auto-upgrade (no GP 2WW needed); do not code/refer coronary calcification (QRisk only).
- Fungal Nail Infection — Pathway while local lab studies are unavailable: topical amorolfine 6 months (+ miconazole for athlete’s foot) first-line; oral terbinafine second-line with baseline and 3-monthly LFTs.
- Palliative Care — Hospice Advice Line & WHISPAR — 24/7 advice line 01942 525566; WHISPAR single point of access for referrals (over-18, Wigan resident/GP); lists District Nurses, Marie Curie, 14-bed inpatient unit (no respite).
- Gambling Support Services — Signs of gambling harm and self-referral routes: local (Beacon Counselling Trust, NHS Northern Gambling Service, EPiC HOPE) and national (GamCare 24/7, Gamblers Anonymous).
- Dyslexia Support — No NHS pathway; diagnosis via educational assessment (school- or self-funded); signposts to bdadyslexia.org.uk. (stub)
Community teams & services
- RAEI Contact Directory — Royal Albert Edward Infirmary numbers: switchboard 01942 244 000, specialty wards, SDEC/Frailty SDEC/SAEC, TIA/VTE/GAU clinics, CRT, community phlebotomy, home blood transfusion team.
- Community React Team (CRT) — 2-hour rapid response to avoid admissions; triage 0300 707 1221, 08:00–20:00 daily. Covers Hospital at Home (IV abs, sub-cut fluids), Community Respiratory, ACPs, home blood transfusion, night/end-of-life team.
- Virtual Ward — Remote monitoring alternative to admission; refer via 0300 707 8919; inclusion/exclusion for acute frailty (65+), CHF, COPD, surgical; no internet needed; contraindications (delirium, eGFR under 30, etc.).
- Crisis Harbours — Drop-in mental-health crisis alternative to A&E (no appointment); Wigan town-centre site at 8 Crompton Street WN1 1YP, plus timetable of Ince/Scot Lane/Orrell/Shevington/Abram locations via EPiC HOPE.
- Wigan Specialist Community MH Team — Merged MHUR/CMHT service; emergencies to 24/7 crisis line 0800 953 0285 (no form); standard referrals via GMMH Adult CMHT form to SCMHTReferrals@GMMH.nhs.uk; urgent 7-day / routine 28-day targets.
- Dieticians — Supplements rarely prescribed in primary care (GMMMG); refer via SystmOne “Referral to Nutrition and Dietetics”; criteria BMI under 18.5, 5% loss in 3–6 months, or 10% in 6+ months.
- Consultant Connect (Pan-GM A&G) — Live across all GM practices: telephone (answered ~30 sec), photo messaging, and email specialist advice; app or browser; support 01865 261467.
Prescribing & certification
- Antibiotic Choice — GMMMG antimicrobial guidance (v16, Oct 2024); RAEI microbiologist via 01942 244 000 for allergy/failure; SystmOne flags broad-spectrum prescribing missing a Read code; repeats need “Antibiotic prophylaxis indicated” (413555000).
- Fit Notes — Self-cert 7 days, fit note from day 8; can be backdated with evidence; no signature needed; phased-return steps and “May be fit for work” guidance; ESA for unemployed patients.
Reference
- Useful Online Resources — Curated external links: GM Formulary, GMMMG antimicrobials, CKS, NNT, NICE NG12 cancer, HRT/UKMEC/UKTIS, RightBreathe, asthma/COPD plans, lipid and hypertension flowcharts, steroid/emollient ladders.
Referrals
How to refer, grouped by urgency and type. Always check current 2WW criteria before an urgent cancer referral.
Cancer (2-week wait)
- Two Week Wait (2WW) Referrals — Cancer referral workflow: Lexacomm dictation first (priority 2WW), complete the Word template form, pre-referral tests (MSU for raised PSA, FIT+FBC for lower GI), verify demographics and UK availability for the next 2 weeks.
Urgent & same-day
- Hospital Admissions — Medical via SDEC 0300 707 2361 (Mon–Fri 09:00–21:00, weekends 11:00–19:00; email letter to wwl-tr.sdec@nhs.net even via 999); surgical via 01942 244 000 (SAU/bleep 6656); paeds bleep SHO via switchboard.
- Medical SDEC — Same-day RAEI assessment avoiding admission; general/condition-specific exclusions (NEWS ≥5, GCS ≤14, haemodynamic thresholds) with cutoffs for chest pain, PE, DVT, GI bleed, AF; discuss on 0300 707 2361.
- Frailty SDEC — RAEI SDEC for 65+ with frailty syndromes (75+ reduced mobility/polypharmacy, 85+ auto screen-in); ECG reviewed by clinician required first; full exclusion list; discuss 0300 707 8579.
- Surgical Ambulatory Emergency Care (SAEC) — RAEI urgent surgical review; inclusion (abdominal pain, PR bleed, abscess, post-op/wound, adults 16+, GCS 15, NEWS under 5) and exclusions (AAA, SBO, pancreatitis, upper GI bleed); discuss 0300 707 8579.
- Surgical Hot Clinic — Urgent outpatient surgical review (e.g. perianal abscess); clinician-only referral by phone 01942 778 663, dictate letter and give the patient a printed copy.
- Urgent Treatment Centre (UTC) — RAEI minor injury/illness unit; patients attend A&E first to be streamed; inclusion (e.g. chest pain under 30y, DVT, burns) and exclusions (cardiac chest pain, stroke, abdominal pain over 70); queries 01942 244 000.
- Acute ENT — Same-day acute ENT clinic (Orrell Ward) for urgent microsuction/antibiotic ointment; phone RAEI switchboard 01942 244 000 and speak to on-call ENT.
- Same-Day Chest X-Ray — Paper X-ray request marked “urgent” handed to patient at Thomas Linacre or Leigh (Mon–Fri 9am–5pm) to avoid admission; only where CXR changes primary-care management.
- TIA Clinic — RAEI clinic for resolved suspected TIA (symptoms under 24h, no longer active); SystmOne “Referral to TIA Services” form then dictate. If active, treat as stroke — 999. Discuss 01942 773 596.
- VTE Clinic — RAEI outpatient clinic for suspected DVT/VTE work-up; excludes upper-limb VTE, query PE, pregnancy, immobility, very acute (all to SDEC); discuss 0300 707 2267, outpatient direct 0300 707 3331.
- Gynaecology Assessment Unit (GAU) — RAEI unit for early-pregnancy pain/bleeding and acute gynae; phone triage required before sending — call 0300 707 2568 and await acceptance.
Diagnostics & monitoring
- Echocardiogram — Via “Cardiology Diagnostic Test Referral” form; commonly rejected without ECG and BNP attached; accepted for high BNP, new murmur/AF/LBBB, surveillance, familial — not LVH alone.
- Paediatric ECG — Surgery cannot ECG under-18s; under-16s via paediatrics (WWL won’t accept GP ECG referrals), 16–18 via the normal WWL adult ECG pathway.
- Paediatric Audiology — Parental self-referral for children; download the WWL form or phone 01942 482 450.
- Audiology (adults) — Direct referral form for hearing aids/tinnitus (18+, Leigh Hospital or Specsavers); check wax first (olive oil TDS 3 weeks); routing table for unilateral/bilateral loss, sudden SSHL, tinnitus, balance to ENT vs Audiology.
- Home BP Monitoring — For clinic BP over 140/90; if patient has a machine, print BIHSoc/SystmOne HBPM diary; if not, send to reception to join the machine waiting list; GP reviews readings.
MSK & rehab
- Orthopaedics — No direct GP referral — all via MCAS/MCATS tier-2 physio triage; guidance on whether to image first (“will the scan change management?”) and re-referral of prior orthopaedic patients.
- Physiotherapy & MSK — Self-referral physio (preferred, saves 1–2 weeks) vs MSK CATS/MCAS tier-2 triage for complex/possible-surgery; First Contact Physios are not for GP referral.
- Joint Injections — Steroid injections (knees, shoulders; hips need GA so not primary care) by Dr John Morgan, Dr Justin Tankard, Dr Lauren Smith; assess and consent first, then patient books at reception.
Mental health
- Compassion in Action — Non-clinical Leigh-based charity taking Wigan-wide self/professional referrals (low mood, anxiety, PTSD, ADHD, autism); open-ended model, Oasis/Haven residential beds, 24hr phone; refer via pam@compassioninaction.info.
- Psychology (CBT & counselling) — CBT via Think Wellbeing self-referral 01942 764449 / Talking Therapies, or Making Space online CBT (book at reception); counselling self-referral via Bridgewater 01942 483 483.
Tools, social care & routine
- Using Lexacomm — Dictation/letter system for sending forms to secretaries; do not task secretaries — speak or send a voice note; includes YouTube tutorial. (stub)
- Waiting List Support — WWL first-appointment chase 01942 264910 (give to patient; do not use secretaries to chase); follow-ups via the specialist’s secretary; links to WWL waiting-times spreadsheet and whileyouwait.org.uk.
- Adult Social Care — Wigan Council professional referrals for care needs, equipment/adaptations, respite, carer and financial assessments; new online Professional Referral Form pending (email/post no longer accepted); safeguarding uses a separate form.
- ENT (routine) — Routine ENT ~12-month wait (Saturday Super Clinics), Audiology ~20 days, A&G within 2–3 working days; specialist clinics; expedite only for significant worsening/new symptoms.
- Long Covid Clinic — Pre-referral workup mandatory: CXR within 4 weeks plus FBC, TFT, haematinics, ESR, U&E, LFT, calcium, vitamin D; then verbal dictation for referral.
- Emergency Dentist — Self-referral for emergency dental treatment: 0333 332 3800. (stub)
Systems & daily admin
How to actually do things in SystmOne, Docman, Lexacomm, and AskMyGP.
- Software Guides — Hub linking to Lexacomm, SystmOne letters/tasks, and AskMyGP picture viewing. (stub)
- SystmOne Tasks — Sending tasks (recipient, patient-readable description, red flag + due date for urgent); who to task (Reception Buddy, Lynn/Emily when buddy away); do not task secretaries — use Lexacomm.
- Discharge Summaries — Communications & Letters → right-click document → View Updates for action history; click the Incoming tab to filter outgoing/MCAS/district-nurse letters.
- Viewing Pictures (AskMyGP) — Patient photos don’t appear in flows/messages search — follow the linked YouTube tutorial (720p); AskMyGP login required, request access from reception admin or Sean.
- Docman Letter Processing — GP workflow for incoming letters: forward standard patients to Reception Buddy (Week 1 phone x3, Week 2 Accurx, Week 3 letter then close); vulnerable patients annotated “Return if no contact” and not closed; backlog ~2 months.
- Lab Add-On Bloods — Phone add-on requests no longer accepted; email biochem2@nca.nhs.uk with patient ID, sample URN, time taken, and tests required.
Investigations & results
- Patient Journey (tests) — End-to-end test workflow: ICE requesting, sample collection, label printing, supply cupboard location; urgent blood rules (only for same/next-day bloods; patient must attend within 48 hours; WWL urgent service 07:45–15:00 from 12 Oct 2026); result turnaround table (bloods 24–48h, MSU, stool, H pylori); no-contact rule for normal results and safety-netting for lost samples.
- Routine Paediatric Bloods — Children’s Community Nursing Team clinics (under-12s) at Leigh, Platt Bridge, Claire House; booking 01942 481345/481230; urgent-request criteria and email; duty phone 07901 110 910.
Consultations & documentation
- Consultation Documentation — SystmOne test patient (Mickey Mouse) load steps; entering Read Codes vs Problems vs free text; flagging existing problems; pre-diabetes coding example.
- Why Is the Patient Here? — Recognising “odd” consultations using Calgary-Cambridge (ICE expectations) and Balint (“ticket to entry”); QOF recalls, mismatched expectations, wrong-department visits.
- Interpreter Services — Language Line phone interpreting: 020 771 30090, access code L20263; setup for telephone vs face-to-face; do not use family members.
Admin, operations & patient services
- Secretaries & Correspondence — Lexacom dictation/referral routing (specialty in Recipient box), typing delays (~3 weeks), waiting-times table (e.g. adult ADHD 7+ yr, GI urgent 18 mo), urgent-CXR same-day hours, PIU Hb-below-80 1-week target, who to task.
- Patient Transport — Self-referral for NWAS PTS: Wigan booking 01942 482 990 (Mon–Fri 08:00–18:00), call over 7 days before the appointment with NHS number; eligibility decided by the transport service.
- Be Well Services — Self-referral community fitness/nutrition (LTC classes, Active Ageing, gym from £33/month; gym 11+/swim 8+). The 12-week adult weight-management and Let’s Get Movin programmes ended 1 Apr 2026 — do not refer.
- Sexual Health Clinics — Wigan (66A Standishgate WN1 1UW) and Leigh (Leigh Health Centre WN7 1HR), now run by Locala; book via 01942 949167.
- Staff Bike Loan Scheme — Free Hindley PCN bike borrowing: scan QR at store, accept disclaimer, return next working day; enquiries Amanda Ormesher 01942 366814; own risk, helmet/lock required.
Safeguarding
- Adult Safeguarding — Care Act 2014 framework and abuse-types table; Wigan online referral portal (email/post no longer accepted); NHS GM centralised safeguarding inboxes live from 26 June 2026; 999/101 guidance.
- Domestic Abuse — History-taking checklist (abuse type, coercion, children, pregnancy, safety, suicidality); Wigan Borough Domestic Abuse Service 01942 311 365 (07:00–19:00) for low-risk self-referral; Safelives DASH checklist; higher-risk pathway needs senior input.
Onboarding (foundation doctors)
- Clinical Supervision — Find your supervisor via the Appointment Ledger; FY supervisors Sean Cusack (ext 7522), Justin Tankard (7543), Sanjay Wahie (7548); contact-method guidance and Telephone Extensions spreadsheet path.
- Smartcards — NHS Smartcard essentials (prescriptions, ICE, fit notes); contact Lynn or Emily (Reception Supervisors, back office) for missing/expired/mispermissioned cards.
Portfolio
- Curriculum Resource Links — Free learning modules (e-LfH, BMJ Learning, Doctors.net) mapped to each Foundation Professional Capability, for working towards curriculum points or ARCP evidence.
- FPC Reference (copy + paste) — All 13 Foundation Professional Capabilities with the capability description in capitals (ready to paste into your portfolio) and the F2 behavioural descriptors for each, from the UKFP Curriculum 2021 (2026 Revision).
- Supervisor Training Resources — Reference document pack from the NHS England (NW) Foundation School supervisor training course: UKFP Curriculum 2021 (2026 Revision), PSG/TAB guidance, Horus report forms, ARCP guidance and NW policies, each linked to the archived PDF and its original source.
Wiki management (meta)
- Requested Content — How to contribute (new page or add to the list) plus the FY-suggested topic backlog tracking what still needs writing.
- Content Categories — Planned content taxonomy (Pennygate Organisational, Resources, Meta) with a checklist of intended pages.