​​​​​​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:

  • caustic ingestion
  • dysphagia with obstruction from food
  • suspected or known oesophageal foreign body (especially button battery or > 1 magnet).

Local or network guidelines may determine the appropriate specialty or service to manage these presentations.

When public outpatient services are not routinely provided

  • < 4 weeks of vomiting.
  • Infantile reflux or colic.

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Recurrent dysphagia with previous food bolus obstruction and/or decrease of > 2 weight centiles.
  • Persistent or recurrent vomiting with small volume haematemesis.
Category 2
Recommended to be seen within 90 calendar days.
  • Aged > 2 years with reflux and recurrent or persistent dyspepsia despite 2-month trial of proton pump inhibitors.
  • Failure to progress to solid foods (after speech pathology and/or dietetics review).
  • Lack of progression to harder food textures due to swallowing difficulties (after speech pathology and/or dietetics review).
  • Dysphagia without faltering growth and/or weight loss.
  • Persistent or recurrent vomiting (≥ 4 weeks) without small volume haematemesis.
  • Positive Helicobacter pylori testing (stool antigen or urea breath test) in the presence of refractory upper gastrointestinal symptoms and associated with iron deficiency anaemia and/or family history of gastrointestinal cancer. Helicobacter pylori testing not indicated in the absence of above features.
Category 3
Recommended to be seen within 365 calendar days.
  • Nausea with associated weight loss ≥ 2 weight centiles with or without vomiting.
  • Aged > 2 years with painless, effortless regurgitation.

Information to include within a referral

Required

  • Reason for referral.
  • Details of the presenting condition including duration of symptoms.
  • Provisional diagnosis.
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • weight loss (amount and timeframe)
    • ‘Blue Book’, growth charts or any recent growth measurements
    • medical management to date (for example, proton pump inhibitors, Helicobacter pylori treatment).

If available

  • Previous endoscopy or histopathology results.
  • Recent pathology reports.
  • Helicobacter pylori results, including urea breath tests.
  • Relevant imaging 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