Cancer Referral Forms

Cancer Referral Forms

Please use the drop down menu at the bottom of this page to access referral forms for all tumour sites.

Wirral University Teaching Hospital NHS Foundation Trust is currently live for all 2WW referrals to be made via ERS (with the referral proforma being attached within 24 hours). Family history referrals for breast and colorectal can also be made via ERS. All referral forms and referral information are listed below.

Exceptions to the above are:

• Brain and CNS referrals which should be faxed to the Walton Centre NHS Foundation Trust on 0151 529 5769
• Patients with vague symptoms or those who do not meet the tumour specific 2WW referral criteria which should be faxed to Wirral Choose and Book on 0151 604 7172 (using Suspected CUP and MUO Cancer Referral Form)
• Lung referrals which should have a WROCS CXR request (if reported with a “*LUNG TEAM FLAG*”. This will be taken as an automatic referral but please note that if reported with an “ALERT: Serious or unexpected finding. *ACTION REQUIRED*” this will NOT be taken as an automatic referral)
• Suspected Carcinoma of Unknown Primary (CUP)or Malignancy of Unknown Origin (MUO) referral forms can be faxed to Wirral choose and book FAX: 0151 604 7172.  To speak to the Acute Oncology Team regarding a CUP/MOU referral please call 0151 604 7433

OR

• WROCS CT scan request (if CXR is normal but there is still clinical suspicion)

Please review instructions on the Suspected Lung Cancer Referral Form in line with the new lung cancer optimal pathway for Cheshire & Merseyside.

• Bone sarcoma referrals which should be faxed to Oswestry Bone Treatment Centre on 01691 404 268 or Birmingham Bone Treatment Centre on 0121 685 4146.
• Soft tissue sarcoma referrals which should be referred via ERS to Royal Liverpool and Broadgreen University Hospital NHS Trust
• Upper GI referrals which should be emailed to wih-tr.directscope@nhs.net

For any queries please contact Wirral Choose and Book on 0151 604 7720.