Referrals

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.

  • Concerns for septic arthritis/sepsis
  • Complications of disease or therapy requiring emergency review e.g. systemically unwell
  • Patients with acutely painful, hot, swollen joint(s) especially if febrile
  • New neurological features in a patient with previously diagnosed ankylosing spondylitis
  • Unexplained illness or fever in a patient being treated with biologic or immunosuppressant medicines
  • Severe drug reaction to Allopurinol in patients with Crystal Arthritis – Gout and CPPD (pseudogout)
  • Visual disturbance or loss in patients with confirmed/suspected Giant Cell Arteritis / Temporal Arteritis
  • Complications of disease or therapy requiring emergency review in patients with Giant Cell Arteritis / Temporal Arteritis
  • Acute Rheumatic Fever

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 Rheumatology.

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

IMMEDIATE (Appointment within 7 days):

  • Acute, otherwise unexplained, monoarthritis
  • Acute, otherwise unexplained, polyarthritis
  • Patients with a previously diagnosed condition who are acutely unwell e.g.:
  • Chronic idiopathic arthritis (inflammatory arthritis, psoriatic arthritis, axial spondylitis)
  • System lupus erythematosus, myopathies, scleroderma
  • Necrotising vasculitis (anti-neutrophilic cytoplasmic autoantibody-associated vasculitis)
  • Patients on biological agents
  • Age >50
  • Suspected giant cell arteritis e.g. new headache, jaw claudication, scalp sensitivity, tenderness over the temporal arteries, fevers, visual disturbance
  • No other diagnosis is more likely

Rheumatology manages the following conditions. Referrals are triaged based on clinical priority following these guidelines Rheumatology (Adult) Referral Access Criteria (health.wa.gov.au). 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.

Specialist clinics/services include:

  • Inflammatory Arthritis
  • Connective Tissue Disease (CTD)
  • Giant Cell Arteritis (GCA)

Referrals will be returned without this information:

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 and is available Minimum-standards-for-outpatient-referrals-Central-Referral-Service.

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: Rheumatology has an extensive outpatient waitlist for routine referrals.

Consider alternate referral pathways such as:

Named referrals for Rheumatology 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.

The following are not routinely provided in a public Rheumatology service.

Condition

Details (where applicable)

Chronic pain

Fibromyalgia

Osteoarthritis
  • Refer to orthopaedics if requiring surgical management
  • Refer to pain medicine if not requiring surgical management
  • SeeHealthPathways: Osteoarthritis(external site)

Chronic fatigue syndrome
  • Refer to general medicine/pain specialist

Ehlers-Danlos syndrome or hypermobility spectrum disorder
  • Refer to relevant specialty whose symptoms predominate (i.e. pain specialist/orthopaedics/gastroenterology/vascular surgery, depending on symptoms)
  • SeeHealthPathways: Ehlers-Danlos Syndrome(external site)

 

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

The emhs-catchment-map.pdf (health.wa.gov.au) 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: 08/05/2024