When public outpatient services are not routinely provided

Toe walking with full passive ankle range of motion.

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Acute toe walking.
  • Abnormal spinal examination.

Category 2
Recommended to be seen within 90 calendar days.

Unilateral toe walking.

Note: If unilateral toe walking, obtain pelvic X-rays to assess for developmental hip dysplasia.

Category 3
Recommended to be seen within 365 calendar days.

  • Persistent toe walking in a school-aged child despite physiotherapy.
  • Unable to dorsiflex feet beyond neutral, stand with heels down or walk on heels.
  • Signs of cerebral palsy with hypertonia, hyperreflexia or ataxia.
  • Calf hypertrophy.
  • Toe walking associated with developmental delay.

Note: Patients with associated developmental delay or suspected hypotonia or cerebral palsy should also be referred to a general paediatrician if not already under paediatric care

Information to include within a referral

Required

  • Reason for referral.
  • Details of the presenting condition including evolution and 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:
    • treatment prescribed (for example physiotherapy, casting, splints)
    • relevant family history (i.e. hereditary neurological condition)
    • neurological examination.

If available

  • Creatine phosphokinase (CPK) level.
  • 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.

Contact us

If you would like to provide feedback about the contents of this page, please submit an enquiry to the SRC project team at NSW Health.

Submit an enquiry

Current as at: Monday 17 June 2024
Contact page owner: System Purchasing