Referral standards and guidelines

You can refer Tasmanians to specialist outpatient services. Referrals must be in writing and include the following information:

• the patient's full name (or alias) and the name of the parent or carer (if the patient is a minor)
• the patient's address
• the patient's telephone number (home and alternative)
• the patient's date of birth
• contact for next-of-kin, carer, guardian and/or local contact (for paediatric referrals)
• hospital Unit Medical Record Number (UMRN) and Medicare number (if known)
• past history including details of previous treatment, investigations including x-rays (photocopied results and films where appropriate)
• presenting symptoms and their duration, and details of any associated medical conditions that may affect the presenting condition, or its treatment (for example, diabetes)
• details of current medications and any drug allergies
• GP diagnosis and categorisation with reference to the pre-referral guidelines where available
• details of current and relevant past medications
• allergies and drug intolerances
• date of referral, details of referring practitioner and GP details (if different from the referring practitioner)
• name of the doctor/clinic to which the patient is being referred.

Additional information

• Patients being re-referred with the same problem will have a letter directed to the original specialist who will arrange an appropriate follow-up appointment at a routine clinic.
• The use of the standard referral template is recommended to ensure the provision of adequate referral content.
• We will ensure referrals include adequate information to allow patient categorisation, prioritisation and direction to appropriate services as per the pre-referral guidelines for First Specialist Assessment.
• We have procedures in place to inform you of appropriate referral content.
• We encourage you to meet referral requirements through regular feedback processes (for example phone, writing)
• We will identify inadequate or incomplete referrals and, where necessary, return the referral for more complete information.

Pre-referral guidelines

To ensure patients are receiving the most appropriate care within the desired timeframe, please ensure that the referral includes all history, examination and examination findings listed in the pre-referral guidelines.

Referral non-acceptance

Referrals to outpatient clinics undergo a triage process prior to an appointment being made. Referrals without all the requested information and investigations for triage will not be accepted and will be returned if:

• it is missing details of medical imaging marked as required in the outpatient guidelines (this is essential to allow efficient triage to be made and is usually more quickly obtained in general practice).
• the referral is missing details of Pathology investigations (these are essential to allow efficient triage to be made and are more quickly obtained in general practice).
• the referral does not contain the required clinical, past and/or family history requested to ensure efficient triage.
• some services are not provided on an outpatient basis.
• referrals must be legible to ensure that no mistakes are made in the triage process
• for an appointment to be made it must be possible to identify and contact the patient, this includes details of parents/guardian in the case of a minor (all referrals with insufficient demographic information will be returned to the referrer)
• the requested service is not routinely funded
• referrals are not made to the correct service (we have developed publically-available guidelines to ensure patients are seen by the most appropriate clinician)
• when the patient’s condition has significantly changed (a new or updated referral needs to be sent – their position on the waiting list will not be reviewed by the resending of the original referral without additional information)
• when the service is not offered by the Department as it is better managed in the community.

Where there is a dispute about the non-acceptance of a referral a letter should be sent to the clinic in the first instance. It will then be appropriately investigated including referral to General Practice Liaison.

Active life of referral

As per the Medicare referral rules outlined in A Guide to Medicare and other HIC health programs (available on the Medicare website), referrals issued by:

• A GP to a specialist referral – remains valid for a single course of treatment (an episode of care) or for a period of 12 months from the initial specialist outpatient consultation, whichever is the lesser. GPs can indicate a shorter, longer or indefinite period for a referral.
• A specialist-to-specialist referral - remains valid for a single course of treatment (an episode of care) or for a period of three months from the initial specialist outpatient consultation, whichever is the lesser.

An episode of care commences at the initial consultation, continues through treatment and concludes when the patient is returned to the care of the referring practitioner. For a referral for chronic or long-term conditions that will extend beyond three or 12 months, the referring practitioner will detail the patient's clinical condition and whether they will require continuing care and management by a specialist (for example, renal and oncology referrals. In these instances, the wording on the referral must indicate that the referral is valid for an ‘indefinite period’.

Visit our outpatient services website for more information