Buying health services for local people

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Hernia repair – Information for GPs

Referral criteria / commissioning position

Referrals to secondary care for:

Ventral Hernia, Para-umbilical & Epigastric:

  • Symptomatic with Patient complaining of pain and/or atrophic skin changes

Ventral Hernia & Incisional hernia:

  • Symptomatic
  • Asymptomatic but increasing in size

Groin Hernia:

  • Inguinal hernia:
  • visible on clinical examination and symptomatic
  • visible on clinical examination but asymptomatic if patient opts for repair (GP to make patient fully aware of risk/benefits)
  • large inguinal/inguinal scrotal (for opinion, even if asymptomatic)
  • no hernia visible on clinical examination but other symptoms present and other intervention (physiotherapy or treatment with anti-inflammatories) unsuccessful

Red flag symptoms

  • Incarcerated hernias – i.e. irreducible hernia, associated with increasing pain, require admission for surgical attention

Investigations prior to referral

None

Information to include in referral letter

  • Description of symptoms and duration
  • Details of treatments and measures tried including outcomes
  • Relevant past medical/surgical history
  • Drug history (prescribed and non-prescribed)
  • Current regular medication
  • BMI
  • Smoking status
  • Alcohol consumption

Patient information leaflets

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