There are a number of specialties across NCL that cannot be referred to through RSS and would require a direct referral to the service provider. These include:

• two-week wait (2WW) referrals
• acute referrals to A&E
• attention deficit hyperactivity disorder (ADHD), learning difficulties, behavioural issues (paediatrics)
• advice and guidance
• anticoagulation
• child and adolescent mental health services (CAMHS)
• clinical oncology
• chronic kidney disease (CKD)
• community physiotherapy
• community podiatry
• chronic fatigue syndrome
• dental
• diagnostic imaging (X-rays, ultrasounds)
• diagnostics/investigations (ECG, 24-hour tape)
• district nurses
• expediting appointments
• gender identity
• general correspondence
• health visitors
• low clearance health
• mental health
• musculoskeletal (MSK, exception in Barnet where referrals go via RSS)
• obstetrics
• occupational therapy
• private referrals
• radiology (exception in Barnet where MRI requests must go via RSS)
• rapid access chest pain (RACP)
• sexual health
• smoking cessation
• social services
• speech and language
• substance misuse
• teledermatology
• transient ischaemic attacks (TIA).