Common reasons for cancellation

RMS check list


Without the following information in the referral letter the RMS may cancel the referral:




  • Orthopaedic/MSK

Most referrals require up to date appropriate imaging, usually in the last 6 months

Conservative measures should be completed, eg physiotherapy, podiatry, injections


  • Endometriosis

Ultrasound within 3 months of referral


  • Cardiology

Recent ECG attached


  • Audiology

Ears must have been examined and clear of wax - please state this clearly in the referral letter


  • Cataract

Must have an optician report attached


  • Gallstones

Require an ultrasound and LFT blood result


  • Sleep apnoea

Needs an Epworth score and mention of CPAP therapy


  • Commonly referred POLCPs*  (should be managed in primary care)

Bowen’s disease

Removal of benign skin lesions


  • Other

Patients that have been seen by a specialist outside the county need the appropriate letters attached


Please note when referring that if there are reasons for referring outside the guidelines please mention these in the referral letter and the referral will likely go through (with the exception of the CCG POLCP rules).



*Procedure of low clinical priority, as designated by the CCG