HNY Policy and Pathway Repository - Humber

This pathway is for primary care referrals, for MRI studies, within the Hull University Teaching Hospitals NHS Trust (HUTH) MRI Department via the NHS e-referral service (eRS).

The HUTH MRI Department offers magnetic resonance imaging to primary care patients at Hull Royal Infirmary (HRI), Hull; Castle Hill Hospital (CHH), Cottingham, Hull and East Riding Community Diagnostic Centre (CDC), Hull; and  at various other locations across the Humber and North Yorkshire through the use of mobile MRI scanners.

Cauda Equina Syndrome Red Flags, see https://gettingitrightfirsttime.co.uk/wp-content/uploads/2025/07/National-Suspected-Cauda-Equina-Pathway-September-2025.pdf

An emergency referral to the nearest facility with Emergency MRI provision is warranted for a patient presenting with leg pain and/or back pain plus a suggestion of recent onset (14 days or fewer) or deterioration of any of the following symptoms:

• difficulty initiating micturition or impaired sensation of urinary flow.
• altered perianal, perineal, or genital sensation S2-S5 dermatomes – the area may be small or as big as a horse’s saddle (subjectively reported or objectively tested).
• severe or progressive neurological deficit of both legs, such as major motor weakness with knee extension, ankle eversion, or foot dorsiflexion.
• loss of sensation of rectal fullness.
• sexual dysfunction – inability to achieve erection or to ejaculate, or loss of genital sensation.

Please see Neurosurgery Page 

GP advice and guidance process with HUTH Radiology Department

• If a referrer has a question regarding a Radiology referral, the query should be sent to Radiology, before submitting the imaging referral, via advice and guidance in the NHS eRS system. This will ensure the subsequent referral is appropriate and directed to the correct modality.
• Radiology regularly check for advice and guidance submissions with the aim to respond within two working days
• Queries will be directed to the on-call Radiologist, the Acute Cover Neuroradiologist or an Acute Cover MSK Radiologist, as appropriate.
• Radiology will reply to the advice and guidance via NHS eRS (this will be visible in the practice NHS eRS work list).
• If query is resolved, then the GP will need to 'End the conversation' or 'Refer Now' if a referral is required. If the Pre-authorization in eRS A&G has been selected by primary care, the service will change the A&G to a referral as indicated by the clinician.

PLEASE NOTE: Once a response has been received and no further action is required, please ensure you click the “end conversation” button within the worklist screen. If the conversation is not ended it will remain on the provider’s worklist.

Please inform the patient that: -

• They may be contacted by a call or text message to arrange the appointment.
• They will receive a text message reminder.
• They may be in the department between 30 and 90 minutes depending on the requested examination.

DO NOT REFER

For patient presenting with Cauda Equina Syndrome Red Flags, see https://gettingitrightfirsttime.co.uk/wp-content/uploads/2025/07/National-Suspected-Cauda-Equina-Pathway-September-2025.pdf , an emergency referral to the nearest facility with Emergency MRI provision is warranted.

All other referrals will be triaged, if inappropriate for MRI a report will be issued, see below.

Referral

All referrals must be submitted via NHS eRS (Diagnostic Imaging/MRI)

In accordance with MHRA guidance, Safety Guidelines for Magnetic Resonance Imaging Equipment in Clinical Use:

1. Referrals can only be accepted from a registered medical practitioner, dental practitioner or other health professional who are entitled refer individuals for MRI at HUTH.
2. It is the responsibility of the referrer to identify those patients with implants and/or contraindications to MRI before referral.
3. Referrers need to supply sufficient medical data (such as previous diagnostic information or medical records) relevant to the MRI examination to enable the accepting clinician to decide on whether there is a hazard associated with the exam.

Referral Criteria

If a referral is required, please ensure that the following criteria are met (as per the referral form): -

• Patient details and contact telephone/mobile number are correct.
• Clinical reason for referral is added.
• Any access or mobility issues the patient may have – to assist with appropriate appointment aligned to access requirements.
• Safety declaration (as below) with additional details where noted: -
  • Do they have a pacemaker or defibrillator? Please include pacemaker/implant details on referral i.e. Name/make model no etc.
  • Have they had heart surgery or heart valve replacement?
  • Have they had surgery to their head/eyes/ears/spine?
  • Have they ever had a brain haemorrhage/aneurysm clip?
  • Does the patient have any stents?
  • Have they had an operation in the last 6 weeks?
  • Have they ever had a penetrating eye injury involving metal? 
  • Do they have any artificial implanted devices?   
  • Is the patient pregnant?
  • Is there any renal impairment? If yes, what is the current (within the past 2 months) GFr?

Appointments

Routine Appointments

• When referrals are received in MRI they will be triaged, and if they meet the criteria set in the guidance, they will be prioritised on clinical details and appointed appropriately.
• Ambiguous or limited information may result in the incorrect clinical question being interpreted when the request is reviewed. A clear clinical question which can be answered by imaging will optimise the usefulness of the study and prevent delays in the acceptance of the referral.
• If referrals do not meet the criteria (above)they will be registered as a "CANCELLED EXAMINATION". A report stating why the request was cancelled along with relevant advice regarding alternative imaging or pathways will be generated. The report will be emailed via the radiology e-results system with a yellow1 notification code to highlight the cancellation.

Appointment information

Appointments are usually sent to the patient via the post/NHS App/ Acute Trust Digital System, and a reminder Text message is shared to mobile phones. If the appointment is offered less than 10 days in advance, the patient will be contacted via telephone/text. Please ensure a contact number is available on the request form. Appointments are given between 07:45hrs to 19:00hrs Monday to Sunday. The length of the appointments varies. Please ensure that the patient is aware that they may be in the department between 30 and 90 minutes, depending on the requested examination.

The patient may also receive a text message reminding them about their appointment. Text messages are sent at 7 days and 2 days before the appointment. To ensure the patient receives a text reminder please inform us of the patient’s mobile number on the MRI request form.

We allocate appointments according to the next available appointment slot. Some examinations can only be provided at certain sites. 

https://digital.nhs.uk/services/e-referral-service

https://gettingitrightfirsttime.co.uk/wp-content/uploads/2025/07/National-Suspected-Cauda-Equina-Pathway-September-2025.pdf

• Hull University Teaching Hospitals