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 

  • Lyell McEwin Hospital (08) 8182 9000, during business hours. After 5:00 pm contact either of the CALHN services. 

Southern Adelaide Local Health Network

Inclusions

  • skin checks for high-risk patients e.g.
    • patients with a previous history of Gorlin syndrome
    • patients on immunosuppressive therapy (including transplant patients) with history of multiple SCC in previous 2 years
    • patient with a history of multiple dysplastic naevi (≥ 100 moles with atypical features > 8mm)
    • patients with multiple non-melanoma skin cancer (MSC)

Exclusions

  • routine skin checks
  • congenital melanocytic naevi (unless > 20cm diameter)
  • extensive actinic keratosis

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • nil

Category 2 (appointment clinically indicated within 90 days)

  • nil

Category 3 (appointment clinically indicated within 365 days)

  • skin checks for high-risk patients e.g.
    • patients with a previous history of Gorlin syndrome
    • patients on immunosuppressive therapy (including transplant patients) with history of multiple SCC in previous 2 years
    • patient with a history of multiple dysplastic naevi (≥ 100 moles with atypical features > 8mm)
    • patients with multiple NMSC (> 2 per year)

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.

  • reason for referral including details of what makes the patient ‘high-risk’ e.g. immunosuppressive drugs including type, specify underlying medical condition, history of frequency of skin cancers, type to be specified
  • provide relevant supportive pathology and imaging reports
  • past medical history, in particular skin cancers
  • current medications

Additional information to assist triage categorisation

  • colour photograph/s of lesion/s if relevant

Clinical management advice

  • we also recommend your patients perform photography on their moles for home surveillance in between their visits to yourself.
  • for extensive actinic keratosis, please consider cryotherapy or topical efudix cream (twice daily for up to three weeks). If non-responsive to this treatment, consider referral.

Clinical resources

Consumer resources

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.