Glossary for state-wide referral criteria

​​The structure for state-wide referral criteria in NSW are divided into five criterion.

In some cases, component(s) may not be applicable to each presenting condition. This will be denoted by ‘Nil’.

Emergency

• Clinical presentations or ‘red flags’ where referring health professionals should consider redirecting the patient to an Emergency Department or urgent care service, or seeking medical advice (e.g. phone on-call medical practitioner).
• These criteria should not be used by referring health professionals to refer to an NSW public specialist outpatient service.

Out of scope (not routinely provided)

• Symptoms, conditions and/or presentations that would not routinely be provided by NSW public specialist outpatient services (i.e. could be optimally and safely managed in primary care).
• These criteria acknowledge and permit exceptions, where clinically appropriate.

Access and prioritisation

• Symptoms, conditions and/or presentations that advise referring health professionals, clinicians, patients and carers suitability for management by NSW public specialist outpatient services.
• These criteria are classified by expected clinical urgency category and clinically recommended timeframes to be seen for a new outpatient appointment (i.e. Category 1: within 30 days, Category 2: within 90 days, Category 3: within 365 days).
• These criteria are only applicable where NSW public specialist outpatient services exist and manage the identified presenting condition .

Required information

• Mandatory information that is to be supplied with referrals to NSW public specialist outpatient services for specific symptoms, conditions and/or presentations.
• These criteria support with the determination of an appropriate clinical urgency category.

Additional information (if available)

• Optional information that can be supplied with referrals to NSW public specialist outpatient services for specific symptoms, conditions and/or presentations.
• These criteria support with the determination of an appropriate clinical urgency category, however, are not required to continue referral processing.