Healthy London Partnership > Resources > Pan London Suspected Cancer Referral Forms – EMIS web

Pan London Suspected Cancer Referral Forms – EMIS web

An updated version of the Pan London Suspected Cancer Referral Forms are now available for EmisWeb, SystmOne, Vision and DXS. Once the new forms have been installed please deactivate and remove all old versions.

In March 2021 the referral forms were updated and:

  • All forms are now compatible with both Read codes and SNOMED codes
  • Test results from past 6 months are now automatically populated (previous range was 3 months).
  • Indication of the patient’s risk of severe COVID-19 has been removed as a required field [this was added temporarily during the first wave of the COVID-19 pandemic]. Referrers can still record this if necessary, via the ‘additional clinical information’ box.
  • Telephone icons removed from all forms

Further changes have been made to the Haematology, Lower GI, Urology, Lung, Breast and Upper GI forms and can be viewed here.

If you are a GP practice within the following CCGs, DXS have uploaded the referral forms centrally to your practice’s IT system:

  • Lambeth
  • Wandsworth
  • Merton
  • Bexley
  • Kingston
  • Richmond
  • Herts Valley
  • Southwark
  • Croydon
  • Lewisham
  • Greenwich

GPs, Dentists and Optometrists across all CCGs in the London area are advised to use these forms when referring patients with a suspected cancer as they contain the updated guidelines from NICE published in 2015 (NG12) as well as additional tumour specific referral criteria and deviations which have been agreed for the London area.

As well as the referral forms, there is also information on how to alter field codes on the referral forms in EMIS and Vision.

If you are using an older version of Internet Explorer, you may have problems downloading the forms.  Please try using another web browser i.e. Google Chrome. If the problem persists please email


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