Department of Health Sir Charles Gairdner Hospital
 
Referring Patients

Emergency Department

Patients requiring emergency medical attention should be referred directly to the emergency department at SCGH.  GPs are requested to telephone the emergency department on 1800 247 205 or  6457 4266 in advance and to fax relevant medical information to 6457 2620.  Written information should also be sent with the patient.

Referrals

All routine referrals should be sent to the Central Referral Service (CRS) - see below.

If you think the patient should specifically be seen at SCGH (rather than another hospital) then please indicate why on the referral. If you think the patient requires immediate review (within seven days) then you should contact the Registrar of the relevant specialty – if they agree the patient needs immediate review then you can fax your referral direct to SCGH to the number the Registrar gives you (SCGH does not have a central fax). The Clinical Services Directory contains further information on services available at SCGH and fax numbers.

How does CRS process referrals?

After a referral is received by CRS the postcode catchment area for the patient is identified (closest site to their home). The services available at that site are reviewed to determine if it is suitable for the patient’s presenting problem and their past medical history. Review of previous presentations across hospitals is taken into account in determining where is best suited to the patient’s requirements. Allocation is determined and the referral sent to that site for triaging.  Sometimes the clinician on triaging at that site may decide another site is more appropriate for this particular issue and send it back to CRS with a comment as such. These comments are used to redirect the referral to the suggested site.

The referring Dr receives a fax from CRS informing them when a referral has been received by CRS, and when accepted by a site, and the patient receives a SMS or letter when the referral is accepted by a site.

Where should  “immediate” referrals be sent to?

”Immediate” referrals (patients needing immediate review within seven days) should be sent direct by the referring GP or Specialist to the hospital clinic after they have spoken with the clinic Registrar or Consultant.  This includes acute fractures. “Immediate” referrals should not be sent to CRS.

All referrals to CRS are reviewed within 24 hours (excluding 4pm Friday to 8am Monday) by a nurse to look for any “immediate” referrals that have been sent to CRS by mistake, and also to identify “priority” referrals, e.g. identified cancer (these  referrals are  sent to the correct hospital site within 24 hours of review by the nurse) .

Should referrals be sent to both CRS and the hospital clinic?

No. A Referral should only be sent to CRS or a hospital clinic, not both.  Only “immediate” referrals or those that are “out of scope” (see later paragraph) should be sent direct to a hospital clinic. Sending the same referral to both CRS and a hospital creates confusion and may delay a referral being processed. If a non immediate referral has been sent directly to a hospital clinic by mistake then the hospital will forward the referral to CRS for processing.

Does CRS allow referral to a named specialist?

Yes. All referrals to a named specialist are sent by CRS to the clinic where the specialist works.  Note in some instances the specialist no longer works at a clinic, or the clinic will decide review by another hospital’s clinic is more appropriate. In this case the hospital will return the referral to CRS who will redirect it to another clinic.

Can CRS allocate referrals to a hospital even if the patient lives outside that hospitals catchment area?

Yes. In general, referrals are directed to the clinic nearest to where the patient lives. Exceptions to this include referral s to a named specialist at a different hospital, where the treatment required is only available at another hospital, where the referring Dr gives good reason in the referral as to why a patient should be seen at another hospital e.g. a long standing patient of another hospital, or country patient with support close to a particular hospital, transport issues. It is up to the hospital site to accept or reject the referral. CRS may also redirect referrals if a new service opens, or if an existing service identifies they have too long a waitlist

Which referrals should not be sent to CRS (“are out of scope”)

The scope of the service was intentionally kept narrow in the first instance based on the volume of referrals entering the system on a daily basis. The intention was to review those services left out of scope in time to be potentially brought into scope.

Currently, the following referrals should NOT be sent to the Central Referral Service:

  • Referrals for patients who require immediate review (within next seven days)
  • Referrals to a private specialist
  • Referrals to Mental Health Services
  • Referrals to rural outpatient services
  • Referrals to Allied Health outpatient services
  • Referrals for obstetric clinics
  • Referrals to non-Doctor led outpatient services (e.g. nurse led clinics)
  • Re-referrals for the same problem (should be sent direct to the hospital where the patient was originally seen)

Outpatient Referral Content

Referrals to specialist outpatient services must be in writing (eg. letter, facsimile, electronic file) and include the following information:

  • The patient’s full name (or alias) and where appropriate (eg. for a minor) the name of the parent or caregiver.
  • The patient’s address.
  • The patient’s telephone number (home and mobile).
  • The patient’s date of birth.
  • Next of Kin / carer / guardian / local contact for paediatric referrals.
  • Hospital Unit Medical Record Number (UMRN) and Medicare number (if known).
  • Sufficient clinical information to allow appropriate triage of the referral. This should include GP diagnosis, presenting symptoms, physical findings, past history including details of previous treatment, and investigations (photocopied results). Where appropriate include details of facility where previous treatment has been provided, including date.
  • Details of current medications and any drug allergies (including reaction to anaesthetics).
  • Date of referral, details of referring doctor and GP details if different from the referring doctor and the name of the doctors/ clinic to which the patient is being referred.
  • Interpreter requirements.
  • Patient height and weight or BMI(essential for obese patients)

Referrals which do not contain sufficient information to allow accurate grading of the priority of the referral will be returned to the referring doctor.

How do I refer to CRS

Referrals to CRS should be made by a Dr (GP or Specialist) or nurse practitioner – do not give to the patient to send to CRS. Referrals may be sent to CRS electronically (preferred), by fax, or by mail..

Healthlink Secure Messaging: ‘crefserv’

Fax: 1300 365 056
Post: PO Box 3462, Midland WA 6056

What referral forms can be used

It is preferred that Drs use referral forms available from the Department of Health GP website: www.gp.health.wa.gov.au.  This site contains referral forms for adult referrals, paediatric referrals and obstetric and gynaecological referrals (currently, obstetric referrals should be sent direct to a hospital clinic). Template forms compatible with practice software may be downloaded (Best Practice, Medical Director, MedTech, ZedMed, Genie and Practix). If a referring Dr chooses not to use the standard template, minimum referral criteria will still be a requirement. Note referrals written on a Drs Letterhead will also be accepted on the proviso that they contain minimum referral criteria (see above).

Queries

If Drs have any queries regarding referral requirements, please contact the Central Referral Service on 1300 551 142. For queries regarding an “immediate” referral (requiring treatment within seven days) contact the Registrar or Consultant of the relevant specialty.

 
 
 
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