Charter Medical Services

1. Who can I refer for gastrosocopy?

GP practices from Manchester, Stockport and Tameside can refer - other PCTs please contact us.

2. How long is the waiting list?

We do not have a waiting list - there is normally an administrative lead-time of about 2 weeks

3. How are appointments made?

Choose and Book, letter, request form or Fax - we will contact the patients and arrange a convenient time. Patients can change their appointment at any time. For Choose and Book patients please let us have the referral letter immediately as patient prep instructions are necessary.

4. Do you use sedation?

Patients can choose to have sedation or xylocaine spray - the ratio is approx 1:3 in favour of spray.

5. What about patients who need referral on to secondary care?

We refer all cancer cases directly on to secondary care and ensure the pathway is followed. Other referals (uncommon) are the The GPs responsibility

6. Should I test and treat (for Helicobacter) before referral?

For patients under 50 with simple dyspepsia NICE guidelines currently suggest a serum HP antigen test and eradicate if positive. Patients with Red Flag symptoms or recurrence after treatment should be referred for gastroscopy. (See our guidelines).

7. Which patients are unsuitable for referral?

Patients should be abulatory and not have very severe cardiopulmonary disease, should be over 17 years old and not within 2 months of an MI. Patients with current or very recent gastrointestinal haemorrhage should be admitted to hospital, and those with severe and progressive dysphagia (likely to require dilatation) should be referred urgently to secondary care (we do not dilate).

8. Can diabetics be referred?

Yes both NIDDM and IDDM.

9. What about patients on Warfarin?

Gastroscopy is safe in warfarinized patients if their INR is below 3. It is helpful to have an INR done within 7days of the test or else we can do it on arrival at the unit. For lower GI examinations, the patient should stop warfarin 7 days before the test (if safe to do so).

10. What about patients on Clopidogrel and Aspirin?

Gastroscopy is safe for both drugs, and the drugs should continue.

Lower GI examination is safe on Aspirin, but Clopidogrel should be stopped 7 days before the test IF SAFE TO DO SO. Some decisions on safety of stopping Clopidogrel are difficult and should involve the patient's consultant.