​​​​​​​​​Emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice via phone to on-call consultant/registrar:

  • acute haematemesis or melaena
  • acute lower gastrointestinal bleeding in large volume or with haemodynamic compromise.

When public outpatient services are not routinely provided

  • Non-significant haematochezia (i.e. small, fresh rectal bleeding on wiping) responsive to trial of laxatives.
  • Thriving infant with minor rectal bleeding (i.e. food protein-induced allergic proctocolitis). Referrals from paediatricians for allergic proctocolitis remain in-scope.

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Persistent haematemesis, melaena or rectal bleeding with any of the following features:
    • faltering growth (weight loss of > 2 weight centiles)
    • iron deficiency anaemia
    • persistent diarrhoea (bloody or non-bloody) > 6 weeks
    • elevated inflammatory markers (raised platelet count, C-reactive protein, erythrocyte sedimentation rate and/or reduced albumin).
Category 2
Recommended to be seen within 90 calendar days.		Persistent haematemesis, melaena or rectal bleeding without any of the above features.
Category 3
Recommended to be seen within 365 calendar days.		Suspected colonic polyp with minimal rectal bleeding.

Information to include within a referral

Required

  • Reason for referral.
  • Details of the presenting condition.
  • Provisional diagnosis.
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • ‘Blue Book’, growth charts or any recent growth measurements
    • full blood count (FBC)
    • liver function test results
    • iron studies
    • c-reactive protein (CRP)
    • erythrocyte sedimentation rate (ESR)
    • coagulation studies.

If available

  • Faecal multiplex PCR results.
  • Faecal helicobacter pylori antigen.
  • Faecal calprotectin result if diarrhoea > 6 weeks (in children aged ≥ 4 years).
  • Previous investigations and reports (e.g. endoscopy, radiological reports).
  • If the patient identifies as Aboriginal and/or Torres Strait Islander.
  • If the patient is considered ‘at risk’ and/or among a vulnerable, disadvantaged or priority population.
  • If the patient is suitable for virtual care or telehealth.
  • If the patient has special needs or requires reasonable adjustments to be made.
  • If the patient requires an interpreter (if so, list preferred language).

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.

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Current as at: Sunday 12 May 2024
Contact page owner: System Purchasing