Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • nil

For clinical advice, please telephone the relevant specialty service.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network 

Southern Adelaide Local Health Network

Exclusions

  • aesthetic surgical procedures
  • anal dermatological conditions without underlying/suspected Colorectal diagnosis – consider referral to dermatology
  • asymptomatic anal tags

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • suspected malignancy
  • suspected anal mass or anal intra-epithelial neoplasia (AIN)

Category 2 (appointment clinically indicated within 90 days)

  • overt rectal bleeding without concerning features
  • suspected anal fistula
  • severe anorectal pain unresponsive to first-line management
  • chronic anal fissure present for longer than 6 weeks/unresponsive to first-line management
  • anal warts

Category 3 (appointment clinically indicated within 365 days)+

  • pruritis ani
  • anal dermatological condition with underlying/suspected colorectal diagnosis
  • symptomatic haemorrhoids
  • symptomatic anal tags

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • past medical/surgical history
  • family history specific to bowel cancer, irritable bowel disease, and polyposis
  • medications and allergies
  • smoking/alcohol and other drug status
  • age
  • height/weight
  • if suspected malignancy, a history of:
    • altered bowel habits
    • rectal tenesmus
    • incomplete rectal emptying
    • presence of blood, pus or mucus in stools
    • mass
    • previous management trialled, duration and efficacy
  • examination findings+
    • abdominal
    • anal inspection findings and/or digital rectal examination, note sphincter tone
  • reports of prior gastroscopies, colonoscopies or polypectomy and pathology of specimens removed where relevant

Additional information to assist triage categorisation

  • relevant diagnostic/imaging reports including location of company and accession number

Reason for request

  • to establish a diagnosis
  • for treatment or intervention
  • for advice and management
  • for specialist to take over management
  • for a specified test/investigation the General Practitioner cannot order
  • for other reason (e.g. rapidly accelerating disease progression)
  • transfer of care from another tertiary service
  • clinical judgement indicates a referral for specialist review is necessary.

Patient demographic details

  • full name, including aliases
  • date of birth
  • residential and postal address
  • telephone contact number/s – home, mobile and alternative
  • Medicare number, where eligible
  • name of the parent or caregiver, if appropriate
  • preferred language and interpreter requirements
  • identifies as Aboriginal and/or Torres Strait Islander

Clinical modifiers

  • impact on employment
  • impact on education
  • impact on home
  • impact on activities of daily living
  • impact on ability to care for others
  • impact on personal frailty or safety
  • identifies as Aboriginal and/or Torres Strait Islander

Other relevant information

  • Willingness to have surgery, where surgery is a likely intervention.
  • Choice to be treated as a public or private patient.
  • Compensable status, e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.
  • Relevant social history, including identifying if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf.
  • Triage of a specialist outpatient referral is based on clinical decision making to allocate an appropriate urgency categorisation.
  • Where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
  • A change in patient circumstance (such as condition deteriorating or pregnancy) may affect the urgency categorisation and should be communicated as soon as possible.
  • All new referrals will be triaged by a consultant and appointment times scheduled according to clinical urgency.