Good morning, This is our updated website. We are still working on it. Your feedback will help us improve it.
[Skip to Content]
Wirral University Hospital NHS Foundation Trust

Site Search

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)
  • Vague Symptoms Service is available for GP’s to refer patients who have symptoms that are suspicious of cancer but do not fit into any of the current 2ww pathways.  It is accessible via WROCS/ERS.  To discuss a referral please call the Vague Symptoms team on 0151 604 7714
  • 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.

  • Cancer Referral Forms arrow icon
    • Suspected Cancer Referral Forms (Referrals to WUTH) arrow icon
      • Suspected Breast Cancer Referral Form Modified: 01/08/2018 10:30AM | Download:
      • Suspected CUP and MUO Cancer Referral Form Modified: 01/08/2018 10:30AM | Download:
      • Suspected Gynaecological Cancer Referral Form Modified: 01/08/2018 10:30AM | Download:
      • Suspected Haematological Cancer Referral Form Modified: 07/08/2018 10:28AM | Download:
      • Suspected Head and Neck Cancer Referral Form Modified: 01/08/2018 10:30AM | Download:
      • Suspected Lung Cancer Referral Form Modified: 01/08/2018 10:30AM | Download:
      • Suspected Skin Cancer Referral Form Modified: 01/08/2018 10:30AM | Download:
      • Suspected Upper GI Cancer Referral Form Modified: 01/08/2018 10:30AM | Download:
      • Suspected Urological Cancer Referral Form Modified: 01/08/2018 10:30AM | Download:
      • Suspected Colorectal Cancer Referral Form Modified: 11/10/2018 2:50PM | Download:
    • Suspected Cancer Referrals Additional Information (Referrals to WUTH) arrow icon
      • Suspected Cancer Referral Patient Letter Modified: 01/08/2018 10:31AM | Download:
      • Suspected Skin Cancer Referral Information Modified: 01/08/2018 10:31AM | Download:
      • Suspected Upper GI Cancer Referral Information Modified: 01/08/2018 10:32AM | Download:
      • Suspected Urological Cancer Referral Information Modified: 28/08/2018 11:00AM | Download:
    • Suspected Cancer Referral Forms (Referrals to other Trusts) arrow icon
      • Suspected Brain and CNS Cancer Referral Form Modified: 01/08/2018 10:33AM | Download:
    • Suspected Cancer Referrals Additional Information (Referrals to Other Trusts) arrow icon
      • Suspected Sarcoma (Bone) Cancer Referral Information Modified: 01/08/2018 10:33AM | Download:
      • Suspected Sarcoma (Soft Tissue) Cancer Referral Information Modified: 01/08/2018 10:34AM | Download:
    • Family History Referral Forms (Referrals to WUTH) arrow icon
      • Breast Family History Referral Form Modified: 11/10/2018 2:52PM | Download:
      • Colorectal Family History Referral Form Modified: 11/10/2018 2:51PM | Download: