​​​​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:

  • abscess (for example peritonsillar abscess or quinsy)
  • acute tonsillitis with any of the following:
    • breathing difficulty
    • stridor
    • sudden voice change
    • systemically unwell
    • unable to tolerate oral intake
    • uncontrolled fever.

When public outpatient services are not routinely provided

  • Patient is not willing to have surgical treatment.
  • Recurrent tonsillitis where episodes are fewer than described in Category 3 criteria, and no modifying factors are present.

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Abnormally appearing or asymmetrical tonsils with:
    • drenching night sweats in the absence of infection
    • u​​nexplained weight loss (≥ 10% of body weight over 3 months).
  • Suspected unilateral tonsil mass or ulcer.
    Note: include if recurrent tonsilitis is associated with cervical lymphadenopathy.

Category 2
Recommended to be seen within 90 calendar days.

Severe complications associated with infection (for example febrile convulsion, neurological sequelae).

Category 3
Recommended to be seen within 365 calendar days.

Chronic or recurrent infection with fever or malaise, decreased oral intake and any of the following:

  • ≥ 7 episodes in the last 12 months
  • ≥ 5 episodes per year in the last 24 months
  • ≥ 3 episodes per year in the last 36 months
  • Sleep apnoea due to tonsillar hypertrophy
  • Tonsillar concretions with halitosis
  • Absent from work, university or college for 4 weeks in a year due to tonsillitis
  • ≥ 1 episode of quinsy.

Information to include within a referral

Required

  • Reason for referral.
  • Details of the presenting condition, including impact on activities of daily living and/or quality of life.
  • Provisional diagnosis.
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • smoking history
    • tonsillitis episode history.

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.

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