Wide Bay Hospital and Health Service Specialist Outpatient ...

1 Wide Bay Hospital and Health Service Specialist Outpatient referral guidelines and Queensland Health clinical prioritisation criteria Date: July 2020 Printed versions may not be up to date For the most recent version, please refer to: Wide Bay Hospital and Health Service : Queensland Health Clinical Prioritisation Criteria information: referral guidelines and clinical prioritisation criteria V6 2020 0 Wide Bay Hospital and Health Service Specialist Outpatient referral guidelines and Queensland Health clinical prioritisation criteria Version control This version was approved by Acting Executive Director of Acute Hospitals and Community Services on20/09/2019.

2 For further information please contact: Specialist Outpatients Departments Wide Bay Hospital and Health Service | ABN 67 558 031 153 This work is licensed by the State of Queensland (Wide Bay Hospital and Health Service ) under a Creative Commons Attribution (CC BY) International license. You are free to copy, communicate and adapt this annual report, as long as you attribute the work to the State of Queensland (Wide Bay Hospital and Health Service ). To view a copy of this license, visit Wide Bay Hospital and Health Service 2019. An electronic version of this document is available at Wide Bay Hospital and Health Service respectfully acknowledges the Traditional Custodians of the land and water on which we work and live.

3 We pay our respects to Elders and leaders past, present and emerging. referral guidelines and clinical prioritisation criteria V6 2020 1 Contents WBHHS Unavailable Services 3 WBHHS referral guidelines and Clinical Prioritisation Criteria 4 Additional Information required for all referrals 5 Diabetes and Endocrinology (Adult) 6 Adrenal insufficiency 6 Adrenal Mass 6 Diabetes Mellitus 7 Disorders of salt and water 8 Glucocorticoid excess (Crushing s syndrome) 8 Hypercalcaemia 8 High-risk foot (Diabetes & Endocrinology) 9 Hypertension (Endocrine) 9 Hyperthyroidism 10 Hypocalcaemia 10 Hypothyroidism 10 Hypogonadism & infertility male 11 Insulinoma 11 Hypoglycaemia unrelated to diabetes 11 Lipids 11 Oligo/ amenorrhoea 12 Hirsutism 12 Acne 12 Female infertility 12 Osteoporosis and metabolic bone disease 13 Pituitary mass 14 Prolactinaemia 14 Thyroid Enlargement 15 Thyroid nodules 15 All other diabetes and endocrinology conditions 15 Diabetes and Endocrinology (Paediatrics) 16 Growth failure 16 Paediatric Diabetes 16 Paediatric Obesity (Diabetes & Endocrinology)

4 17 All other diabetes and endocrinology conditions 18 Endoscopy 19 Colonoscopy 19 Upper GI Endoscopy 20 ENT- Paediatrics 22 Epistaxis 22 Otitis Media acute otitis media with or without perforation 22 Otitis Media with effusion (OME Glue ear) 22 Tonsillitis 23 All other ENT - Paediatric and Adult issues 23 Gastroenterology 24 Abdominal pain (gastroenterology) 24 Altered bowel habit 24 Barett s oesophagus surveillance 25 Bowel Cancer screening 25 Coeliac disease 25 Constipation 25 Diarrhoea 26 Dyspepsia 26 Heartburn 26 Reflux 26 Dysphagia (Gastroenterology) 26 Inflammatory bowel disease 26 Iron deficiency 27 Polyp surveillance 27 Rectal Bleeding 27 General Medicine 29 Anaemia 29 Complex or undifferentiated medical problems 29 Complex Paediatrics patients transitioning to adult services 30 Falls 30 Medication review 31 Poly- Pharmacy 31 Osteoarthritis 31 Gout 31 Joint Pain 31 Pre-operative medical assessment 32 States of altered neurological function 32 Syncope/ pre-syncope (General Medicine)

5 32 Unintentional weight loss 33 Wounds of uncertain cause or non-healing ulcers 33 General Paediatrics 35 Allergic Reactions 35 Asthma, stridor and wheeze 35 Autism spectrum disorder (diagnosed or suspected) 36 Behavioural problem in a child< 6years 37 Behavioural problem in a child > 6years 38 Chronic and recurrent abdominal pain 39 Chronic diarrhea and/or persistent vomiting 40 Constipation with or without soiling 40 Development delay in children < 6 years 41 Faints 42 Syncope 42 Funny turns 42 Faltering growth (failure to thrive) in children 43 Headaches 43 Irritable Infant < 1 year 44 Jaundice 45 Joint Pain 45 Learning difficulty/ disability in children > 6 years46 Murmur (General Paediatrics) 47 Paediatrics diabetes (General Paediatrics) 47 Paediatric obesity (General Paediatrics) 48 Persistent and chronic cough 49 referral guidelines and clinical prioritisation criteria V6 2020 2 Physical findings of concern < 1 year 49 Recurrent respiratory infection 50 Seizures 50 Short Stature 51 Urinary incontinence and enuresis 52 Urinary tract infections (UTI) (General Paediatrics)

6 53 General Surgery 54 Colorectal bowel disease 54 Breast benign and malignant 54 Endocrine Surgery 55 Hepatobiliary/ pancreatic surgery 56 Hernia Repair 56 Perineal disease and faecal incontinence 56 Skin and soft tissue pathology benign and malignant 56 Upper gastrointestional surgery 57 Gynaecology 58 Abnormal cervical screening/cervical dysplasia/ abnormal cervix 58 Cervical Polyp 58 Dyspareunia (deep or superficial) 58 Fibroids 59 Heavy Menstrual Bleeding (HMB) 59 Intermenstrual bleeding 59 Endometriosis (known or suspected) 60 Infertility/RPL 60 Mirena/IUD insertion or removal for HMB or IRT 60 Ovarian Cyst/ pelvic mass 61 Pelvic floor dysfunction (prolapse and/or incontinence) 61 Pelvic Pain 61 Dysmenorrhea 61 PMS 61 Polycystic Ovarian Syndrome (PCOS) 62 Post-cotial bleeding 62 Post-menopausal bleeding (> 12 months since last menstrual period)

7 62 Primary/Secondary Amenorrhoea 62 Vulva lesion/lump 63 Genital warts 63 Boil 63 Swelling 63 Abscess 63 Ulcer 63 Bartholin s cyst 63 Termination of Pregnancy 63 Nephrology Services 65 Acute decline in kidney function 65 Chronic kidney disease 65 Cystic Kidney Disease 66 Glomerulonephritis 66 Haematuria (Nephrology) 67 Hypertension (nephrology) 67 Nephrolithialsis 68 Proteinuria 68 Oncology Services 70 Biopsy proven new diagnosis of lymphoma 70 Breast Cancer 70 Colorectal cancer 71 Head and neck Cancer 71 Lung Cancer 71 Lymphadenopathy for investigation 72 Multiple myeloma 72 Testicular Cancer 73 Ophthalmology Services 74 Cataracts 74 Orthopaedics Services 75 Achilles Tendon pathology and rupture 75 Basal thumb arthritis 75 Dupuytren s contracture (Orthopaedics) 75 Foot and ankle arthritis 75 Ganglia 76 Hand trauma 76 Heel pain 76 Hip Pain 76 Knee Pain (acute) 77 Knee Pain (chronic)

8 77 Lower limb trauma (also see acute knee pain) 77 Pain/deformity in forefoot and hind foot 77 Painful/stiff wrist 78 Peripheral entrapment neuropathies including CTS (Orthopaedics) 78 Shoulder and elbow conditions 78 Spine (Orthopaedics) 79 Stenosing tenosynovitis 79 Upper limb trauma 79 Urology 80 Haematuria 80 Atypical cells in urine 80 Follow up TCC bladder 80 Bladder mass 80 Elevated PSA 80 Rising PSA 80 Recurrent Urinary tract infection (UTI) 80 Urinary tract calculus 80 Testicular/ epididymal, scrotal, penis or foreskin abnormalities 81 Loin Pain 81 Renal mass 81 WBHHS Checklist for referrals 83 Service availability 83 Additional information for all referrals 83 Baseline Observations and Information (Specialty list) 83 Minimum referral Criteria (Specialty list) 83 Index 84 referral guidelines and clinical prioritisation criteria V6 2020 3 WBHHS Unavailable Services The following services are unavailable in the WBHHS and referral to tertiary facility will be required.

9 Service Refer to Cardiology Adults Metro North Cardiology Paediatric Metro North ENT Adults Metro North Genetics Cancer Metro North Genetics General Metro North Genetics Paediatrics Metro North Hepatology General Medical Fraser Coast if urgent or Metro North Malignant Haematology Metro North Neurology Metro North Neurosurgery Metro North Paediatric Nephrology Metro North Paediatric Surgery Metro North Persistent Pain Management Nambour Hospital Plastic and Reconstructive Surgery Metro North Rheumatology Nambour Hospital Respiratory and Sleep Studies Metro North Vascular Metro North All other services are available yet some conditions within the Service will require Tertiary facility referral .

10 This has been identified within the Service CPCs below. referral guidelines and clinical prioritisation criteria V6 2020 4 WBHHS referral guidelines and Clinical Prioritisation Criteria WBHHS referral guidelines were developed and implemented in 2013 in partnership with the Medicare Locals and WBHHS Clinical Directors. WB GPs have been using these as a guide for referral information to ensure the patient is catergorised and seen within the recommended clinical timeframe. These referr