Gastroenterology and Hepatology Referrals

Find assessment and management information on Gastroenterology and Hepatology conditions at:

If any of the following are present or suspected, phone 000 to arrange immediate transfer to the Emergency Department or seek emergent advice if in a remote area.

  • Life threatening symptoms suggestive of:
    • Bowel obstruction
    • Abdominal sepsis
    • Acute severe colitis
    • Acutely large volume rectal bleeding
  • Significant acute upper GI bleeding (e.g. haematemesis, melaena)
  • RPH is an Adult service, referrals for child and adolescent health services should be directed to Perth Children’s Hospital, Referrals-to-PCH (external website).
  • For Country patients please consider a local service, view resources within AHCWA MAPPA (external website).

To arrange an urgent review or advice, please phone the RPH switchboard on 9224 2244 and ask to speak with the on-call registrar for Gastroenterology.

After verbal clinical handover and agreement with the registrar that the patient requires an appointment with RPH within 7 days please email the patient’s referral to:

RPH, Central Referral Receipting RPH.OutpatientReferrals@health.wa.gov.au

Ensure the referral is:

  • marked IMMEDIATE
  • the name of the registrar or consultant spoken with is written on the referral
  • all essential referral information, investigations, clinical photos are included

Gastroenterology (Direct Access Endoscopy) has a Referral access criteria and specific Referral form (external website) in place and manages the following conditions.

Referrals are triaged based on clinical priority following these guidelines

Referral criteria for other Gastroenterology and Liver conditions will come soon. Please send all referrals via Central Referral Service using the General Adult Referral form (external website).

Specialist Clinics/Services include

  • Inflammatory Bowel Disease (IBD) including specialist IBD nursing service
  • Direct access Endoscopy and Gastroscopy
  • Manometry and Capsule Endoscopy
  • Interventional Endoscopy
  • Medical Day Unit
  • Liver Cancer
  • Hepatitis C Remote & Prisoners service

Referrals will be returned without this information

Gastroenterology (Direct Access Endoscopy) has a Referral access criteria and specific Referral form (external website) in place and manages the following conditions.

Referrals are triaged based on clinical priority following these guidelines

Referral criteria for other Gastroenterology and Liver conditions will come soon.

Please send all referrals via Central Referral Service using the General Adult Referral form (external website).

If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the referral.

Minimum Standard Referral is included in the standard referral template Referral-form-templates (external website) and is available Minimum-standards-for-outpatient-referrals-Central-Referral-Service (external website).

Please ensure patient email and mobile phone numbers are included to facilitate patient contact.

Patients can be flagged for Video or Telephone consultations at referral, triage or follow-up.

Please Note: Gastroenterology & Hepatology have an extensive outpatient waitlist for routine referrals. Consider alternate referral pathways such as:

  • Ensuring full condition clinical pathways have been explored via
  • Referral to Contracted Medical Practitioners within EMHS. See our full list of specialists here:
  • Referral to a private or community provider

Named referrals for Gastroenterology & Hepatology will be allocated a suitably qualified specialist to see the patient, noting these referrals are booked based on first on, first off principles from the outpatient waitlist.

Please note that where appropriate and where available, Gastroenterology & Hepatology referrals may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.

Colonoscopy:

Condition

Details (where applicable)

Anaemia not due to iron deficiency

Healthpathways- Iron Deficiency Anaemia (external website)

Positive iFOBT in the context of a recent (within 2 years), complete colonoscopy

Refer to HealthPathways- Screening and Surveillance Colonoscopy for management advice (external website)

If still concerned call on-call Registrar to discuss value of referral for repeat endoscopy procedure.

Patients with diarrhoea ≤6 weeks or those with diarrhoea >6 weeks without evidence of stool specimen

 

Patients younger than 45 years who have altered bowel habit in absence of alarm symptoms

 

 

Referral to public Gastrointestinal endoscopy (direct access) outpatient services is not routinely accepted for the following conditions:

Condition

Details (where applicable)

Anaemia not due to iron deficiency

Healthpathways- Iron Deficiency Anaemia (external website)

Unexplained dyspepsia in absence of alarm symptoms

 

Assessment of extra oesophageal GORD symptoms including choking, coughing, hoarseness, asthma, laryngitis, chronic sore throat, or dental erosions.

 

 

 

Excluded Gastrointestinal endoscopy procedure services – NIL

While the WA Health Excluded Procedures precludes procedures performed for cosmetic or other non-medical reasons, procedures which meet an identified clinical need to improve the health of the patient may be undertaken in public hospitals.

To avoid patients unnecessarily waiting for and attending appointments in cases where surgery cannot be offered at Royal Perth Hospital, referral criteria have been established for abdominal lipectomy, breast reduction, blepharoplasty, male circumcision, rhinoplasty and varicose veins.

Visit the Royal Perth Hospital - Excluded Procedures Outpatient Referrals (health.wa.gov.au) page for more information.

The following are not routinely provided in a public service:

  • Plastics – Abdominal lipectomy & Breast reduction
  • Ophthalmology - Blepharoplasty
  • Ear, Nose & Throat (ENT) - Rhinoplasty
  • Urology – Male Circumcision
  • Vascular – Varicose Veins

EMHS is responsible for providing public health services to the people who reside within its boundaries. 

The emhs-catchment-map.pdf outlines the suburb catchment areas for East Metropolitan Health Service (EMHS). The country areas that flow to EMHS are Kimberley, Pilbara and Wheatbelt.

Referral to a hospital for assessment and/or treatment is based around multiple criteria. These include:

  • Place of residence – most hospitals have catchments to help service people closer to home. For country patients, the residence of family with whom they will reside whilst attending appointments can be taken into consideration.
  • Age – RPH is an Adult Hospital, children are only treated by some hospitals.
  • Hospital location of specialty services – some conditions need designated specialist services that are not available at all hospitals.

Please use this information to guide referrals to the hospital servicing your patient's residence and inform your patients of these criteria when you are referring them for public hospital services via the Central Referral Service (CRS).

Last Updated: 11/07/2023