Statewide Specialist Clinic Referral Criteria

Clinical review

From 1 November 2022 Victorian public hospitals will begin to implement the revised suite of statewide referral criteria.

A review of statewide referral criteria published between 2018-2020, conducted by Clinical Review Panels, has been completed. This brings the full suite up to date with the latest advice and clinical guidelines. Several criteria now also include reference to ongoing symptoms post acute COVID-19 infection.

Where to find statewide referral criteria

Referring clinicians will find the statewide referral criteria on all Victorian HealthPathways websites (or equivalent*) or visit src.health.vic.gov.au

What happens when a referral is incomplete or declined?

• Referrals that do not meet the statewide referral criteria are expected to be declined by all Victorian public hospitals. When a referral is declined, referring clinicians should receive correspondence from the health service explaining why the referral has not been accepted.
• If a referral is declined due to being incomplete – that is, it is missing essential information – the referring clinician must resubmit again in full. Patients will not receive an appointment or be placed on an appropriate waitlist until a complete specialist clinic referral has been received.

The role of PHNs

All six Victorian PHNs will support the implementation of statewide specialist clinic referral criteria in primary care. Statewide project management and coordination is provided by VTPHNA to ensure a consistent and coordinated approach. The objectives of this project are:

1. Improve GP confidence and capacity to manage high volume and/or low complexity conditions in the community.
2. Support and participate in the development of consistent statewide referral criteria for public specialist clinics.
3. Facilitate general practice and other primary health clinicians to adopt and comply with the statewide referral criteria, where applicable.
4. Improve the quality of referrals from GPs/primary health to acute public specialist clinics.
5. Support GPs and other referring clinicians to navigate their local health system and accurately refer to appropriate health services through the provision of referral pathways.

Key PHN activities include:

• Development and publication of clinical and referral content for the nominated specialities, including the statewide referral criteria, on all Victorian HealthPathways websites or the South Eastern Melbourne online care pathway platform.
• Development of a statewide communication and engagement plan that is implemented locally, to promote and raise awareness of the statewide specialist clinic referral criteria among primary health practitioners.
• Support the development of a statewide specialist clinic referral directory and wait list registry.

PHN mechanisms

• Provider engagement and training
• Clinical support
• Localised care pathways

Communications toolkits

PHNs and other stakeholders can use these communications toolkits to raise awareness of the statewide referral criteria for:

• Managing referrals to non-admitted specialist services policy
• Long COVID

*or the SEMPHN online care pathways website for GPs in the South Eastern Melbourne PHN catchment.