​​​​Emergency

If melaena or haematochezia, haematemesis or vomiting in large volume or with haemodynamic compromise is 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.

When public outpatient services are not routinely provided

Normochromic, normocytic anaemia with normal iron studies or isolated low serum iron.

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

  • Reason for referral.
  • Details of the presenting condition, including symptoms and their duration.
  • Provisional diagnosis.
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • non-steroidal anti-inflammatory use
    • weight loss (amount and timeframe)
    • any previously received iron therapy (duration and timing)
    • family history of gastrointestinal cancer or coeliac disease
    • dietary history, including red meat intake
    • menstrual history, familial haemoglobinopathies, blood donations
    • full blood count
    • haematinics (iron studies, red blood cell count, folate, vitamin B12)
    • coeliac serology (total immunoglobulin A (IgA), tissue transglutaminase (tTG) with or without anti-endomysial antibody (EMA)).

If available

  • Faecal Occult Blood Test (FOBT) result.
  • Previous endoscopy or 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’ 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: Sunday 12 May 2024
Contact page owner: System Purchasing