Patients should have an X-ray of the affected joint(s) confirming severe osteoarthritis prior to referral for hip or knee arthroplasty. For further guidance, please refer to the Arthroplasty RefHelp page:

Patients with clinically significant isolated neck nodes should be referred directly to ENT neck lump clinic for consideration of biopsy. They do not need additional referral to Haematology - please see RefHelp's Lymphadenopathy page:

Lothian Eating Disorders Service (LEDS) is a specialist outpatient service for patients >18yrs with an eating disorder diagnosis. It offers a variety of psychotherapeutic techniques dependent on individual needs. Detailed info here:

Incretin based therapies could reduce exposure to oral progestogens used as part of HRT, & compromise the essential endometrial protection the progestogen confers. Prescriber MUST advise the user about interactions with other medications. More advice here:

The recent RefTalks on Asthma guidelines recording is now available on RefHelp. Please watch the outstanding presentations here: Please do give us your valuable feedback to further improve the webinars for you:

Please advise patients who are planning to travel to countries where rabies is a recognised risk to consider pre-exposure rabies vaccination (chargeable vaccination). They may book an appointment with the NHS Lothian Travel Clinic via:.

For guidance on the local referral process following animal bites and potential rabies exposure, please consult the Infectious Diseases section on RefHelp:.

A big thank you to Dr Tracey Bradshaw and Katie Johnston for a fantastic talk on Asthma guidelines. A special thank you to Dr David Millar for chairing the session and our wonderful audience for your participation. The recording will soon be available on RefHelp. #watchthisspace.

Join tonight's RefTalks exploring latest advancements in Asthma management through AIR & MART therapies. Led by respiratory care experts, this talk will help you manage Asthma patients effectively, in accordance to the latest guidance. Dedicated Q&A time!

Meadows Child & Adolescent Trauma team is a small specialist service within CAMHS providing a multi-disciplinary & systemic approach to children & young people facing difficulties following experiences of specific trauma. More details here:

Recently updated & clearly outlined referral guidelines for Infectious Diseases here: In particular issues relating to TB including asymptomatic contacts of those with active TB infection should be referred directly to TB specialist nurses, and not ID.

Register for the #RefTalks in June. Key speakers will focus on AIR & MART treatment regimes, the role they play in the new BTS/NICE/SIGN guidance & how to implement these effectively. Useful tips on diagnosis & indications for referral are also discussed.

Have you watched the new RefBites on CAMHS Eating Disorder in Children & Young People? If not, please view the short video here: Please do give us your feedback for future topic suggestions here:

The characteristic ‘bullseye’ targetoid appearance for Lyme Disease is only seen in a minority of cases & the most common skin lesion is a homogenous, expanding rash > 5cm without central clearing. Please see details for testing, treatment, referral & PIL:

Next #RefTalks in June will provide updates on AIR & MART treatment options in the context of the BTS/NICE/SIGN asthma guidelines & associated implementation guidance. Don’t miss this opportunity to enhance your clinical knowledge. Register now!

Two new RefBites on 'Creating a RefHelp page' and 'Creating a Sci Gateway Pathway' recently published on RefHelp. Watch Here: Please do give us your valuable feedback:

The RefTalks on Migraine Treatment Update by Dr Mireia Moragas is now available on RefHelp Please don't forget to give us your feedback

The next #RefTalks is on revolutionising Asthma management covering new AIR & MART treatment regimes, implementation, including tips on diagnosis and advice on when to refer to secondary care. Exclusive Q&A session included so hurry and register now:

Woman Inclusive Sexual Health Extended Service (WISHES) is an accessible, non-judgemental, and holistic service for women with high and complex sexual health needs. Detailed information about the service & referral guidelines here:

Scottish Government has recently changed the prescribing regulations for the treatment of erectile dysfunction (ED) removing the need for a specialist opinion. For further background information and prescribing details please see here: