​​​​​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.

  • Melaena or haematochezia, haematemesis or vomiting in large volume or with haemodynamic compromise

When public outpatient services are not routinely provided

  • ​Normochromic, normocytic anaemia with normal iron studies or isolated low serum iron.​
    Note: Clinical monitoring within primary care for anaemia secondary to gynaecological, haematological or other causes. Consider faecal occult blood test. Refer to outpatient services if anaemia is progressive, faecal occult blood test is positive or if gastrointestinal symptoms emerge.

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Aged ≥ 40 years and positive Faecal Occult Blood Test (FOBT).
  • Aged ≥ 50 years and negative FOBT, but any of the following symptoms:
    • rectal bleeding
    • change in bowel habit or any lower gastrointestinal symptoms
    • unexplained iron deficiency with or without anaemia (Hb < Lower Limit of Normal).
  • ≥ 5% unexplained weight loss in past 1 month or ≥ 10% unexplained weight loss in past 6 months.
Category 2
Recommended to be seen within 90 calendar days.
  • Aged ≥ 40 years with all of the following present:
    • negative FOBT
    • negative coeliac serology
    • gastrointestinal symptoms
    • unexplained iron deficiency with or without anaemia.
  • Aged < 39 years and recurrent, unexplained iron deficiency or positive FOBT (with or without gastrointestinal symptoms).
  • Serology suggestive of coeliac disease (new or uncontrolled).
Category 3
Recommended to be seen within 365 calendar days.

Aged < 39 years and single episode unexplained iron deficiency and negative FOBT (with or without gastrointestinal symptoms).

Information to include within a referral

Required

  • Duration of symptoms.
  • Any previously received iron therapy (duration and timing).
  • Menstrual history, familial haemoglobinopathies, blood donations.
  • Family history of gastrointestinal cancer or coeliac disease.
  • Dietary history, including red meat intake.
  • Weight loss (amount and timeframe).
  • Non-steroidal anti-inflammatory use.
  • Full blood count.
  • Haematinics (iron studies, red blood cell count, folate, vitamin B12).
  • Coeliac serology: total immunoglobulin A (IgA), tissue transglutaminase (tTG) +/- anti-endomysial antibody (EMA).
  • Patient health summary (including relevant medical history and medications).

If available

  • Faecal Occult Blood Test (FOBT) result.
  • Previous endoscopy / histology reports.
  • Electrolytes, urea and creatinine (EUC).
  • Liver function test result.
  • If the patient identifies as Aboriginal and/or Torres Strait Islander.
  • If the patient is considered ‘at risk’ and/or among a vulnerable, disadvantaged or priority population.

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.​​​

​Contact us

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Current as at: Wednesday 14 February 2024
Contact page owner: System Purchasing