​​​​​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:

  • hoarse voice or other acute voice change associated with:
    • breathing difficulty or stridor
    • haemoptysis
    • moderate to severe neck pain
    • neck swelling
    • neck or laryngeal trauma
    • recent thyroid, neck or laryngeal surgery

When public outpatient services are not routinely provided

Hoarseness with complete resolution between episodes, with no other red flag symptoms (see persistent hoarseness symptoms in Category 1)

Note: consider referral to speech pathologist.

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Patient is stable and has persistent hoarseness (> 4 weeks) with any of the following:
    • dysphagia
    • associated throat or ear pain
    • neck lump
    • haemoptysis
    • past history of head and neck cancer (especially in smokers).
  • Recent change to voice and persistent hoarseness which fails to resolve in 4 weeks and includes a background history of any of the following:
    • current smoking
    • excessive alcohol intake
    • recent intubation.
  • Persistent hoarseness in a patient with a known gastric, lung or ENT malignancy.

Category 2
Recommended to be seen within 90 calendar days.

Patient relies on their voice for profession, and symptoms have not improved following period of speech pathology management.

Category 3
Recommended to be seen within 365 calendar days.

Persistent hoarseness (> 4 weeks) and/or change in voice quality which fails to resolve in 4 weeks and in the ​​absence of risk factors or red flag symptoms.

Note: consider referral to speech pathologist.

Information to include within a referral

Required

  • Reason for referral.
  • Details of the presenting condition, including symptoms and their duration.
  • Provisional diagnosis.
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • if the patient is a professional voice user
    • smoking history
    • alcohol intake history
    • head and neck cancer history.

If available

  • Speech pathology assessment or report.
  • If the patient identifies as Aboriginal and/or Torres Strait Islander.
  • If the patient is considered ‘at risk’ or among a vulnerable, disadvantaged or priority population.
  • If the patient is willing to have surgery (where clinically relevant).
  • 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: Wednesday 2 October 2024
Contact page owner: System Purchasing