Public outpatient services in NSW are generally not provided to patients presenting with these conditions.

On this page

  1. Adult patients (aged 16 years or over)
  2. Paediatric patients (aged 0 to 15 years)

Adult patients (aged 16 years or over)

Presenting condition Out of scope (not routinely provided) criteria
Ankle or foot injury (acute)
  • Diabetic neuropathic conditions.
    Note: consider referral to a High Risk Foot Service.
  • Patients who would otherwise be referred to a fracture clinic.
  • Simple ankle sprain.
Ankle or foot osteoarthritis
  • Clinical symptoms not severe enough to require surgical opinion for intervention.
  • Cosmetic foot surgery.
  • Diabetic Charcot foot.
    Note: consider to referral to a High Risk Foot Service.
  • Osteoarthritis where non-operative management has not been undertaken.
  • Patient already on surgical waitlist in another local health district for the same condition.
Back pain
  • Complex, persistent axial spinal back pain where surgical indications are not present.
    Note: consider referral to a rheumatology or multidisciplinary pain service.
  • Patient already on surgical waitlist in another local health district for the same condition.
  • Spondyloarthropathies.
    Note: consider referral to rheumatology.
  • Uncomplicated fragility fractures of the axial spine.
Hip osteoarthritis
  • Clinical symptoms not severe enough to require surgical opinion for intervention.
  • Osteoarthritis where non-operative management has not been undertaken.
  • Patient already on surgical waitlist in another local health district for the same condition.
Knee osteoarthritis
  • Clinical symptoms not severe enough to require surgical opinion for intervention.
  • Osteoarthritis where non-operative management has not been undertaken.
  • Patient already on surgical waitlist in another local health district for the same condition.
  • Uncomplicated inflammatory arthropathy (including crystal arthropathies).
    Note: consider referral to rheumatology.
Knee pain (acute)
  • Mild knee osteoarthritis or soreness.
  • Uncomplicated degenerate meniscal tears.
  • Uncomplicated inflammatory arthropathy (including crystal arthropathies).
    Note: consider referral to rheumatology.
Scoliosis or kyphosis

Intradural pathology based on MRI.
Note: consider referral to neurosurgery.

Shoulder instability

Patient already on a surgical waitlist in another local health district for the same condition.

Shoulder pain
  • Patient already on a surgical waitlist in another local health district for the same condition.
  • Platelet-rich plasma (PRP) injections for shoulder pain, and repair of long head of biceps ruptures where primary concern is cosmesis.
  • Rheumatological conditions (for example inflammatory arthritis, autoimmune connective tissue or muscle disorders, or osteoporosis without fracture).
Wrist or hand osteoarthritis

Inflammatory arthropathy (including crystal arthropathies).
Note: consider referral to rheumatology.

Wrist or hand pain
  • Patient who would otherwise be referred to a fracture clinic.
  • Uncomplicated inflammatory arthropathy (including crystal arthropathies).
    Note: consider referral to rheumatology.
Non-condition specific
  • Assessment prior to application for the Australian Defence Force, Police, NDIS, disability, pension, release of superannuation.
  • Dupuytren’s nodule without functional impairment or contracture.
  • Non-specific headach​e without red flags concerning features or not requiring surgical intervention.
    Note: consider referral to neurology.
  • Patient already on surgical waitlist in another local health district for the same condition.
  • Patient who would otherwise be referred to a fracture clinic.

Paediatric patients (aged 0 to 15 years)

Presenting condition Out of scope (not routinely provided) criteria
Back pain

Nil out of scope criteria.

Baker’s cyst

Solid mass on ultrasound.
Note: consider diagnoses other than Baker’s cyst (for example tumour) and refer to most appropriate speciality.

Bow legs

Bow legs and aged < 1 year old (in an otherwise normal child).

Club foot

Nil out of scope criteria.

Curly toes
  • Curly toes and child aged < 3 years.
  • Other structural abnormalities (for example webbing).
Developmental hip dysplasia
  • Asymmetric skin creases with normal imaging.
  • Risk factors for developmental hip dysplasia with normal imaging (see Required​ for imaging guidelines).
Flat feet
  • Child aged < 8 years with functional impairment (for example recurrent falls) as a result of flat foot.
    Note: consider referral to physiotherapy.
  • Flexible flat foot (i.e. arch reconstitutes on heel raise) without pain.
In-toeing

Child with in-toeing who has been walking for < 6 months.

Knee injury
  • Chronic recurrent multifocal osteomyelitis (also known as non-bacterial osteitis).
    Note: consider referral to rheumatology.
  • Jumper’s knee.
    Note: consider referral to sports medicine or physiotherapy.
  • Non-traumatic knee pain with no diagnosis in the presence of normal hip and knee imaging.
    Note: consider referral to sports medicine or physiotherapy. Consider referred pain from the hip and hip X-rays.
  • Non-traumatic monoarticular swelling with no structural damage on MRI.
    Note: consider referral to rheumatology.
  • Osgood-Schlatter disease.
    Note: consider referral to sports medicine or physiotherapy.
  • Suspected inflammatory diagnosis (for example juvenile idiopathic arthritis, juvenile rheumatoid arthritis).
    Note: consider referral to rheumatology.
Knock knees

Nil out of scope criteria.

Note: typically children aged 3-4 years have knock knee alignment that improves over time. Reassurance at this age is recommended.

Limp

Nil out of scope criteria.​​

Metatarsus adductus

Nil out of scope criteria.

Out-toeing

Out-toeing and aged < 2 years (in otherwise normal child).

Perthes disease

Nil out of scope criteria.

Scoliosis or kyphosis
  • Kyphosis < 50 degrees in a skeletally mature child without pain.
  • Scoliosis < 10 degrees in a skeletally mature child without pain.
Slipped upper femoral epiphysis

Nil out of scope criteria.

Toe walking

Toe walking with full passive ankle range of motion.

Non-condition specific
  • Assessment prior to application for disability.
  • Ingrown toenail.

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