Supporting information for GPs and health professionals
CDH ECHO referral criteria update
The Direct Access Echocardiography and 24-hour Holter monitoring service, delivered via the Community Diagnostic Hub (CDH) at the New QEII Hospital, Welwyn Garden City, continues to be available to all GPs able to request cardiology tests from East and North Hertfordshire NHS Trust.
Referrals are made directly on ICE, with each test generating a formal consultant cardiologist report that includes management advice. No separate e-RS referral is required, and GPs are reminded not to refer via both pathways in parallel. If there is any uncertainty about the most appropriate route, please use Advice and Guidance (A&G) via e-RS before submitting a request.
Referral criteria
- Suspected heart failure with BNP >400 pg/ml-2000pg/ml.
- For patients with BNP >2000 pg/ml who have not previously been seen in cardiology, referral to the Rapid Access Heart Failure Clinic (which includes echocardiography and a face-to-face review) remains the referral route.
- New murmur identified on clinical examination
- Referrals advised via A&G following consultant cardiologist review
New referral indications as of (27/11/2025)
The criteria for direct access echocardiography have now been expanded to include:
- Family screening for first-degree relatives of patients with bicuspid aortic valve or cardiomyopathy, but not for cardiomyopathy surveillance.
- Patients with known aortic root and/or ascending aorta dilatation requiring follow-up imaging as already advised by a cardiologist.
- Patients with previously identified mild aortic stenosis or mild aortic regurgitation where repeat echocardiography has been recommended by a cardiologist at a 3–5 year interval.
These additions aim to support timely surveillance for patients at increased cardiovascular risk and to ensure continuity of care within primary and community settings.
When submitting requests, please include clear clinical details in the ICE form to support accurate reporting. All referrals should either meet the criteria above or have prior approval from a consultant cardiologist via A&G.
For general service queries, please contact [email protected].
For individual patient queries, continue to use Advice and Guidance.
