When public outpatient services are not routinely provided

Completed colonoscopy with adequate bowel preparation in the last 2 years for the same symptoms.

Colonocopy is not required if already performed in the last 2 years and findings were normal (i.e. no polyps) so long as there are no new symptoms or other indications for more frequent colonoscopy.

Criteria to access public outpatient services

Category Criteria
Category 3
Recommended to be seen within 365 calendar days.

Provide relevant family or personal history that suggests screening or surveillance may be required. These will be co​​nsidered at the receiving outpatient service and triaged accordingly.

  • Colon ​
  • Oesophageal
    • Documented Barrett's oesophagus.
      Note: frequency is dependent upon the length of Barrett's and whether dysplasia was evident on prior biopsy. See Cancer Council guidelines for more information.
    • Personal history of oesophageal cancer.
    • Refer to Upper gastrointestinal dysfunction state-wide referral criteria for more information.
  • Gastric
    • Surveillance in patients with extensive (body and antrum) gastritis with atrophy or gastric intestinal metaplasia of the gastric body.
    • Autoimmune gastritis pernicious anaemia.
    • Personal history of gastric cancer.
  • Pancreaticobiliary
    • New pancreatic cyst with all of the following features:
      • size < 3 cm
      • normal pancreatic duct size
      • without solid component or mural nodule.
    • Chronic pancreatitis
    • Previous history of pancreatic cancer
    • BRCA 1 or BRCA 2 gene, and Peutz-Jeghers syndrome

Information to include within a referral

Required

  • Reason for referral.
  • Details of the presenting condition.
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • family history of colon cancer (including age at diagnosis, 1st or 2nd degree relative)
    • family or personal history that suggests screening or surveillance may be required
    • histopathology report (for previous polyps only)
    • most recent endoscopy and/or colonoscopy report
    • previous MRI report(s) of pancreatic cysts.

If available

  • 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.

​
Current as at: Thursday 14 November 2024
Contact page owner: System Purchasing