Statewide Specialist Clinic Referral Criteria for specialist clinics – Communications pack 2024 Copy

The Victorian Department of Health has developed new ‘companion’ statewide referral criteria to enable direct access to colonoscopy and gastroscopy in public hospitals and health services for category one patients for these selected indications:  

• positive faecal occult blood test (FOBT) – diagnostic colonoscopy 
• dysphagia – diagnostic gastroscopy.  

The new criteria were developed by a clinical review panel of GPs and hospital-based clinicians, who have expertise working with affected patients. They come into effect from 1 February 2024.  

The use of these companion criteria will not be mandatory for referrals for colonoscopy or gastroscopy.  

The need for an endoscopy for other indications should be considered during a consultation between a patient and a gastroenterologist. 

They are intended to replace locally described referral criteria which have until now been used to streamline access for these procedures. They could also support other health services to move to a streamlined access model.  

When a referring GP uses the new criteria to refer a patient to a public hospital that is using a streamlined access model, patients can be placed directly onto the wait list for their procedure without needing to wait for an outpatient appointment. This is why more information is needed in referrals – to support the assessment of anaesthetic and bleeding risk as well as risk factors for poor bowel preparation. 

The Victorian Department of Health is advising public hospitals and health services that do not use a streamlined access model to continue to use the gastroenterology statewide referral criteria for patients with rectal bleeding, persistent iron deficiency and dysphagia. Referrals for all other indications should be assessed against the appropriate gastroenterology statewide referral criteria. Patients would then be reviewed in specialist clinics prior to a colonoscopy or gastroscopy. 

Health services using a streamlined access model have been advised to use these criteria from 1 February 2024 and should publish updated information about making referrals on their websites. 

GPs and other primary care providers should check their local HealthPathways or care pathways website when making referrals – this will be the quickest way to understand their local public hospital’s requirements. 

The new criteria were developed where there are identical indications for the procedure in the Victorian Colonoscopy categorisation guidelines or the Upper gastrointestinal endoscopy categorisation guidelines for adults, national guidelines and the Medicare Benefits Schedule. 

The aim is to: 

• reduce overall wait times for patients through safe, streamlined access to these procedures (patients can be placed directly on the wait list for their procedure, so this means one less appointment for eligible patients) 
• offer choice to referring clinicians (between referral for an endoscopic procedure, or referral to a specialist clinic based on what they know about the patient and their needs) 
• give public hospitals and health services the tools and opportunity to redesign local processes, if and how they want to 
• facilitate access to colonoscopy for the National Bowel Cancer Screening Program 
• support use of eReferrals.