Respiratory and sleep medicine referral access criteria

Respiratory and sleep medicine Referral Access Criteria

Patient requires immediate (within 7-days) attention

Immediate referrals (patient to be seen within 7 days) should be sent directly to the relevant hospital. Do not send immediate referrals via Central Referral Service (CRS).

Contact the on-call registrar or service to arrange an immediate respiratory and sleep medicine assessment for:

Acute Pulmonary Embolism that is clinically stable and started on anticoagulation
- See Clinician Assist WA: Acute General Medicine Assessment (seen within 7 days) (external site)
Haemoptysis without known lung disease
- Medium volume of haemoptysis as defined as expectoration of 30 to 200mls within 24hours
Pleural disorders
- Large pleural effusion+/- suspected malignancy with no hypoxia or respiratory distress
Suspected lung cancer/thoracic malignancy
- Suspected primary thoracic cancer
- Nodule of any size associated with hilar lymphadenopathy, distal atelectasis or pleural effusion
- Significant growth/change of a non-calcified pulmonary nodule on serial chest CT

To contact the relevant services, see Clinician Assist WA: Acute Respiratory Assessment (external site)

Respiratory and Sleep Medicine (adult) conditions with Referral Access Criteria
These conditions are routinely seen by respiratory and sleep medicine (adult) outpatient services. This is not an exhaustive list of all conditions seen by the outpatient service. Consideration for referral will not be excluded unless the condition is listed on the exclusion list. If the condition you are referring for is not listed, or is unknown, please include details in the body of the referral. Referrals missing 'mandatory information' with no explanation provided may not be accepted.
Asthma Bronchiectasis Chronic Suppurative Lung Disease Chronic cough Chronic Obstructive Pulmonary Disease (COPD) Cystic fibrosis Haemoptysis without known lung disease Interstitial lung disease (ILD) Lung cancer/thoracic malignancy Non-calcified Pulmonary Nodules Occupational lung disease Pleural disorders Post COVID Syndrome Pulmonary hypertension Recurrent respiratory infections without known lung disease Sarcoidosis (Pulmonary) Shortness of breath/dyspnoea without a known cause Sleep disordered breathing (suspected or confirmed) Sleep disorders excluding sleep disordered breathing

Respiratory and Sleep Medicine (adult) conditions with Referral Access Criteria

These conditions are routinely seen by respiratory and sleep medicine (adult) outpatient services. This is not an exhaustive list of all conditions seen by the outpatient service. Consideration for referral will not be excluded unless the condition is listed on the exclusion list. If the condition you are referring for is not listed, or is unknown, please include details in the body of the referral.

Referrals missing 'mandatory information' with no explanation provided may not be accepted.

Excluded conditions and services

Exclusions

Referral to public respiratory and sleep medicine outpatient services is not routinely accepted for the following conditions:

Condition	Details (where applicable)
Respiratory Function Testing in absence of a consultation	See Clinician Assist WA: Spirometry Testing and Evaluation (external site)
Chest wall pain with normal chest CT	Consider referral to General Medicine or Chronic Pain Clinic
Non-cardiac chest pain with normal chest CT	Consider referral to most relevant specialty based on assessment Consider referral to physiotherapy if likely musculoskeletal in nature
Occupational Fitness Assessment
Occupational asbestos related lung disease	Significant asbestos exposure or asbestos related lung disease – see Asbestos Review Program (accepts state-wide referrals) (external site)
Direct screening Tuberculosis	See Clinician Assist WA: Tuberculosis (external site) Refer to Western Australia Tuberculosis Control Program (external site)
Tuberculosis/non-tuberculosis mycobacterial infections	See Clinician Assist WA: Tuberculosis (external site) Tuberculosis is a notifiable disease. Report all cases to the Department of Health, preferably within 24 hours of diagnosis If there is any suspicion of TB, even if the risk is uncertain, seek advice from the Western Australia Tuberculosis Control Program (health.wa.gov.au) (external site) If considering arranging diagnostic testing, seek advice from the Western Australia Tuberculosis Control Program (health.wa.gov.au) (external site)

Excluded elective procedures

All elective procedures must meet an identified clinical need to improve the health of the patient. Procedures are not to be performed for cosmetic or other non-medical reasons. Excluded procedures will not be performed unless under exceptional circumstances and where a clear clinical need has been identified. For excluded procedures, the referral must clearly state:

that the request is for an excluded procedure
the clinical exception reason as to why it should be considered

Access the WA Elective Surgery Access and Waiting List Management Policy at WA Health Policy Frameworks.

Excluded procedure	Exceptional circumstance includes
Nil

Last reviewed: 16-08-2024

Respiratory and sleep medicine Referral Access Criteria

Exclusions

Excluded elective procedures

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