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.

  • acute urinary retention
  • severe/uncontrolled haematuria
  • urinary tract sepsis/systemic infection
  • severe/uncontrolled abdominal pain
  • hypertension with abdominal mass

Please contact the on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Women's and Children's Health Network

Exclusions

  • angiolipoma — refer to nephrology
  • asymptomatic renal cyst < 1 cm

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • complex cystic lesion greater than 4cm
  • mucosal/collecting system lesions
  • any solid renal mass
  • suspected malignancy, consider phoning on-call urology registrar to discuss
  • any mass of testis, para-testicular mass or bladder mass. Consider phoning on-call urology registrar to discuss

Category 2 (appointment clinically indicated within 90 days)

  • complex cystic renal mass less than 4cm without suspicion of malignant disease
  • large or symptomatic simple renal cyst
  • suspected pelvic ureteric junction (PUJ) obstruction in child > 12 months of age

Category 3 (appointment clinically indicated within 365 days)

  • nil

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.

  • age
  • past medical/surgical/psychosocial/family history
  • family history
  • current medications
  • allergies and sensitivities
  • presenting symptoms, including:
    • onset
    • duration
    • concerning features
  • height/weight
  • body mass index (BMI)
  • growth chart trends
  • blood pressure trends
  • examination findings
    • abdominal examination
    • scrotal examination, boys
  • urinalysis (dipstick) result

Additional information to assist triage categorisation

  • pathology:
    • complete blood examination (CBE)
    • electrolytes, urea and creatinine (EUC)
    • liver function test (LFT)
    • estimated glomerular filtration rate (eGFR)
    • mid-stream urine (MSU) microscopy, culture and sensitivity (M/C/S)
  • 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.

Adolescents transitioning from paediatric to adult specialist services require a formal handover from paediatric specialist clinician to adult specialist clinician as well as a formal referral from the referring specialist to ensure initial transfer of care is completed.

The General Practitioners role in this process is to provide support to patients as part of holistic care. All ongoing referrals to specialists can subsequently be provided by the General Practitioner once the transfer of care has occurred.