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Royal Brompton & Harefield NHS Foundation Trust
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Tertiary referral form

Tertiary referral form

As a tertiary centre, Royal Brompton & Harefield NHS Foundation Trust is reliant on referring providers to forward 18-week data, particularly with regards to clock start.


The Department of Health has devised an inter-provider transfer administrative minimum dataset (IPTAMDS) by which referring providers can transmit 18-week information.


We ask that all tertiary referrals made to this Trust are accompanied by an IPTAMDS form. Please complete this form and send it to the Trust with the usual standard letter. IPTAMDS data can be emailed to the following secure email address - rbh-tr.interprovider@nhs.net


If you are unsure who to direct the referral to, please go to our consultants pages.


Royal Brompton & Harefield NHS Foundation Trust will ensure that for all patients transferred out to another provider an IPTAMDS form is supplied to the recipient trust. 

Royal Brompton

Sydney Street,
London SW3 6NP
Tel: +44 (0)20 7352 8121