REFERRING YOUR PATIENT
FOR ANTENATAL CARE
A Guide for General Practice
Issued: July 2010
Author: Sarah Oldfield Clinical Information & Referrals Manager Ealing PCT.
020 3313 9332 firstname.lastname@example.org
2010 Referral Guidelines 3
How should practices refer? 3
Maternity Matrix for booking process 4
What information is available for women? 5
What happens if practices refer women to the PCT? 5
What happens if a woman’s referral is sent to more than one unit
at once? 5
What happens if a woman’s referral is rejected from a unit? 5
Where can practices go for further information? 5
Additional Information 6
MATERNITY OPTIONS 7
Maternity Poster 8
Updated: July 2010
2010 Update to the guidelines
Following a period of increased availability at local maternity units practices will now be
responsible for sending all antenatal referrals to an available unit.
These guidelines are to help practices send referrals to the most appropriate maternity
unit available for your patient
HOW TO REFER PREGNANT WOMEN?
All referrals should be sent using the North West London antenatal referral form.
Information should be typed not handwritten. EMIS and Vision compatible forms are
available from the Ealing PCT website
ALL sections of the referral form must be competed, including patient details and
contact telephone numbers. It is essential to include an Estimated Date of Delivery
(EDD) and Last Menstrual Period (LMP). Without these, maternity units can not ensure
women are given the appropriate antenatal appointment.
1. CHOICE: Refer to the Updated Maternity Matrix (page 4) to see which units are
available. Discuss with the woman which available unit they would like to be
referred to and check if they meet that unit’s referral criteria. Current
availability of maternity units is also updated monthly on PCT’s website:
2. GESTATION: EDD is essential and if not known an accurate estimate must be
given so that maternity units can offer appointments within 12 weeks and 6
days. Type all details onto the maternity form, including EDD and LMP.
3. FAX the referral form to the available maternity unit. DO NOT send a
referral to more than one unit. This risks women being unable to get
appropriate care and duplicate referrals being made.
Some units may not accept women if they do not meet their criteria. Please tell
women that the practice needs know if they have been rejected by a unit so you
can find them another unit.
Practices must process referrals for all women. Referrals should NOT be faxed to
PCT’s Maternity Bookings or Clinical Assessment Service.
THE MATERNITY MATRIX GIVES FULL DETAILS OF THE BOOKING PROCESS.
UPDATED: JUNE 2010
MATERNITY MATRIX FOR BOOKING MATERNITY
Client seen at surgery and EDD
Discuss these local maternity units with the client. Further details of additional services offered at these
units are in Maternity Options on page 8 and the PCT’s website: www.ealingpct.nhs.uk
Details of other maternity units can be found on: www.drfosterintelligence.co.uk
Ealing Queen North West Hillingdon West Chelsea & UCLH St Mary’s
Hospital Charlottes’ London Hospital Middlesex Westminster
FAX: 020 University
FAX: 020 8869 2880 FAX: 020
FAX: 020 FAX: 01895 FAX: 020
3313 8518 3312 1831
8967 5633 279613 Fax: 020 7380 9754
Accepts all women. FAX: 020
Always accepts 8321 5040 Accepts all
Accepts all Accepts all
W3 & W4 All deliveries only at FAX referral to ONE unit only. all women.
women. Now open for Accepts women.
postcodes. Northwick Park. Only accepts
all women. mothers with women
A very popular
unit - usually Midwife led birthing Hounslow
postcode, Unable to
full by 8 weeks unit moved to accept
gestation for Northwick Park. registered with
Ealing GP. mothers with
postcodes. No maternity at problems or
Central Middlesex mothers
Women should Hospital Teenage
tell surgery interpreting
immediately if Group
they are not
What information is available for women?
Page 7 of this guide and Ealing PCT’s website:
contain latest information for both women and GPs. The maternity webpage will continue to
be updated with details of admission criteria and catchment areas for all local units, together
with links to websites of local maternity units.
We also enclose a poster to display in your surgeries, encouraging women to book as soon
as they know they are pregnant.
What happens if a woman’s referral is rejected?
Of local maternity units, only Queen Charlotte’s and West Middlesex University Hospital have
strict catchment areas. All other units are open for all women. It is important that practices
stress to women that if they are rejected from any unit, they must let the practice know so you
can arrange a further referral to another unit.
Queen Charlottes: All women living in W3 or W3 postcodes will be accepted, however for
other postcodes, only women at or before 8 weeks gestation are likely to be accepted by
Queen Charlottes. If your patient is over 8 weeks pregnant, please discuss alternatives to
Queen Charlottes and refer to another unit.
West Middlesex University Hospital: For clinical safety reasons a cap on maternity
bookings is in place. They only accept mothers living in a Hounslow postcode area. This
also affects patients registered with Hounslow GPs. If your patient does not live within a
Hounslow postcode, please discuss alternatives to WMUH and refer to another unit.
What if a woman wants a maternity unit not in this guide?
The details in these guidelines focus on the maternity care provided by our nearest local
units. In some circumstances a woman may wish to deliver at another unit outside the local
area. Please contact that unit and if they are willing to take the woman, refer her directly to
What happens if a woman’s referral is sent to more than one unit at once?
If a women’s referral is sent to more than one unit, this greatly reduces the existing capacity
at all maternity units and means some women are unable to access care, whilst others
receive multiple booking appointments. This has the potential to destabilise all maternity
units locally and we stress that WOMEN’S REFERRALS MUST NOT BE SENT TO MORE
THAN ONE UNIT AT A TIME.
We are working with local units to identify areas where duplication appears to be happening.
Where specific practices are identified as sending multiple referrals, these will be contacted
by the PCT and asked to stop.
Where can we go for further information?
If you have any queries please ring Sarah Oldfield on 020 3313 9332 or email
North West London Standardised Maternity Referral Form
A standardised referral form is used by all GPs and maternity units across North West
London to ensure a more effective antenatal booking system. This referral form collects key
information to help maternity units filter cases according to potential risks and help prioritise
the allocation of antenatal appointments. Copies of the forms are available from NHS
Ealing’s maternity webpages. Any queries please contact your IMT Trainer or
Heather Joseph, Heather.Joseph@nhs.net
12 week Medical and Social Risk Assessment
It is recommended that all women have a comprehensive medical and social risk assessment
by 12 weeks of pregnancy. This assessment has become a national standard which PCTs
are monitored against in 2010/11.
Approximately two-thirds of maternity referrals are made at around 10 weeks of pregnancy.
While this is encouraging, a significant number of women continue to book after 12 weeks.
The PCT is exploring various initiatives to help raise awareness of the benefits of accessing
maternity services early in pregnancy (i.e. from 8 weeks gestation).
Investment in Community Midwifery services
NHS Ealing has invested money to increase the number of midwives and midwifery support
workers at Ealing Hospital. We have established midwifery teams based mainly in the
community and accessible from a variety of venues across the borough. The teams will have
a specific caseload of women and will be able to provide individualised and more
personalised care to women during their pregnancy. Further details are available from:
In addition to providing women with greater choice about where they access antenatal and
postnatal care, we are aiming to increase the provision of home births as an option for low
risk pregnancies. It is anticipated that the home birth service will be provided by the
community midwifery teams.
NICE guidelines on antenatal care: http://www.nice.org.uk/guidance/CG62
Department of Health National Services Framework for Children, Young People and
Maternity Services (2004) Standard 11: Maternity Services
Maternity Matters: Choice, access and continuity of care in a safe service (DH 2007)
Review of Maternity Services 2007 - Scored assessment EHT (Healthcare Commission
Healthcare for London, A Framework for Action (July 2007)
Standards for Maternity Care, Report of a working party (Royal College of Obstetricians and
MATERNITY OPTIONS FOR WOMEN
Options for women wishing to book maternity services within North West London sector Updated: July 2010
Hospital Telephone/ Website Catchment Criteria Nuchal Scan Home Birth Midwife Birth
Address FAX (only carried out between Birthing Pool
10-13 weeks gestation) Unit
Chelsea and Tel: 020 8746 8000 www.chelwest.nhs.uk Accepts all mothers. All women Not for women
Westminster 020 8846 7915/7916 living in Ealing
Hospital PCT area
369 Fulham Road, Fax: 020 8846 7910
London, SW10 9NH
Ealing Hospital Tel: 020 8967 5000 www.ealinghospital.org.uk Accepts all mothers. Now available for all Subject to risk
Uxbridge Road, 020 8967 5578 women assessment and
Southall, staffing levels.
UB1 3HW FAX: 020 8967 5633 Ealing Borough
only. Not W3.
Hillingdon Hospital Tel: 01895 238282 www.thh.nhs.uk Accepts all mothers. All women Not for women
Pield Heath Road, 01895 279300 living in Ealing
Uxbridge, Middlesex, 01895 279042 PCT area
FAX: 01895 279613
North West London Tel: 020 8864 3232 www.nwlh.nhs.uk Accepting Ealing Women. All women Not for women Now at
Hospitals – 020 8864 5252 living in Ealing Northwick
Northwick Park All deliveries, including PCT area Park
Hospital midwifery led now at Hospital
Northwick Park Hospital only. only.
FAX: 020 8869 2880
No maternity at Central
Imperial - Queen Tel: 020 3313 1111 www.imperial.nhs.uk Always accepts W3 & W4 All women Subject to risk
Charlotte's and 020 3313 3926 postcodes. assessment. Only
Chelsea Hospital 020 3313 3526 Very popular unit for all women living in
Du Cane Road, postcodes - usually full by 8 QCCH catchment
London weeks gestation for other
FAX: 020 3313 8518 postcodes
Imperial - St Mary's Tel: 020 3312 6666 www.imperial.nhs.uk Accepts all women X Integrated testing Not for women
Hospital 020 3312 1244 available as alternative. living in Ealing
Praed Street, PCT area
Paddington FAX: 020 3312 1831
West Middlesex Tel 020 8560 2121 www.west-middlesex- Only accepts mothers with All women Subject to risk
University Hospital Tel: 020 8321 5007 hospital.nhs.uk Hounslow postcode, assessment. Only
Twickenham Road, registered with Ealing GP. for women living in
Isleworth, Middlesex FAX: 020 8321 5040 area of West
TW7 6AF Teenage Pregnancy Group Middx
University College Tel: 0845 155 5000 www.uclh.nhs.uk Accepts all women. All women Not available for
London Hospital 020 7380 9400 women living in
(UCLH) Unable to accept mothers Ealing PCT area
Elizabeth Garrett FAX: 020 7380 9754 with social problems or
Anderson Hospital, needing interpreting services.
Huntley Street 7
Could you be pregnant?
If you think you may be pregnant, you need to see your GP as early as possible, so that maternity care can be
started and a booking for a scan at 12 weeks of pregnancy arranged to help you and your baby.
If you are planning to get pregnant or are in early pregnancy, you should take Folic Acid before you get
pregnant and for the first 12 weeks of your pregnancy to reduce the risk of infants being born with neural
tube defects such as Spina Bifida. Folic Acid is available from your local pharmacy or GP. The earlier you
see your GP the more likely you are to get the hospital of your choice.
For further information on maternity units available to you, contact