Information including up to date UHB, NBT and Weston EPAC referral forms and guidance can be found here
Guidance and information on how to refer to EPAC
With effect from 2nd June 2025, NBT and UHBW have launched a self-referral option for EPAC clinics if certain criteria are met. See Remedy for self referral criteria details.
The self referral forms can be found here. The link says it is for self referral for Bristol and Weston-Super-Mare. Once the first two boxes have been ticked a drop down menu comes up to select the hospital and Southmead can be selected at this point.
For Clinical referral, please use the same form HERE and select the required hospital.
There are EPAC clinics at St Michaels Hospital, Southmead Hospital and Weston General Hospital. EPAC is an emergency clinic for women with suspected miscarriage or ectopic pregnancy.
Do not refer to EPAC women with known dates less than 6 weeks pregnant with bleeding and no pain – if less than 6 weeks pregnant then CKS guidance 2018 advises the woman to repeat a urine pregnancy test after 7–10 days and to return if the test is still positive, or if her symptoms continue or worsen.
In addition, the Clinical Knowledge Summaries for the management of suspected miscarriage and ectopic pregnancy are useful.
EPAC Referral Criteria
Patients must have:
- Positive pregnancy test and > 6 weeks or < 18 weeks pregnant with bleeding +/- pain
- Positive pregnancy test and < 6 weeks with significant pain +/- bleeding if considering ectopic (but see below information also)
- Previous hydatidiform mole or ectopic pregnancy
After assessing the patient, the referral form can be emailed directly to the relevant Early Pregnancy Clinic. If the patient is already booked for their antenatal care, you must refer the patient to the Early Pregnancy Clinic at that hospital. If the patient is not yet booked, please refer to the hospital which the patient thinks they will book for.
Cases that require discussion with on-call Gynaecology
- Severe pain and/or bleeding
- Haemodynamic instability
- Patients who you feel cannot wait for EPACassessment
- Patients not meeting the clinic referral criteria
- Postnatal women
- Women with problems following medical or surgical TOP
Patients who you feel cannot wait to be reviewed in Early Pregnancy Clinic
- If following assessment, you feel that the patient cannot wait to see EPC the next working day, please ring the on-call Gynaecology SHO.
- In Bristol, the acute Gynaecology take alternates weekly between St Michaels and Southmead Hospitals. To confirm which hospital is on-call the hospital switchboard.
- In Weston, please telephone the Maternity Unit (01934 647 082) or the on-call SHO (via WGH switchboard).
Please click here for up to date information on Remedy.