New ‘companion’ statewide referral criteria for category one patients with specific indications that require colonoscopy or gastroscopy come into effect from 1 February 2024.
The criteria are:
- positive faecal occult blood test (FOBT) – diagnostic colonoscopy
- dysphagia – diagnostic gastroscopy.
It's important to note that the use of the new criteria is not mandatory. They are designed to reduce overall wait times by replacing existing locally described referral criteria, potentially aiding public hospitals and health services to move to a ‘streamlined access model’.
The need for an endoscopy for other indications should be considered during a consultation between a patient and a gastroenterologist. 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 criteria also offer referring clinicians the option to choose between referral for an endoscopic procedure, or referral to a specialist clinic based on what they know about the patient’s needs. The criteria were developed by a clinical review panel formed by the Victorian Department of Health and comprising GPs and public hospital-based clinicians specialising in these patient groups.
They provide public hospitals and health services with tools and opportunities to redesign local processes as needed, while also facilitating access to colonoscopy for the National Bowel Cancer Screening Program and supporting the use of eReferrals.
Richmond GP Dr Jeannie Knapp is a GP advisor at North Western Melbourne Primary Health Network. She said the criteria are good news for patients and another step towards a more consistent health system. "When used appropriately, these new companion statewide referral criteria mean one less appointment for patients who qualify to go to direct to the waitlist for their procedure,” she said. “I’m also hopeful that public hospitals with less efficient referral procedures for these indications can now streamline them.”
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 are encouraged to 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 below can also be accessed via HeathPathways Melbourne or src.health.vic.gov.au:
- National Bowel Cancer Screening Program (NBCSP)
- Positive Faecal Occult Blood Test (iFOBT)
- Dysphagia
- Colonoscopy Surveillance
- Constipation in Adults
- Dyspepsia and Heartburn/GORD
- Iron Deficiency Anaemia
- Non-acute Gastroenterology Referral (> 24 hours)
- Gastroscopy Referral
- Direct Access Colonoscopy Referral
Statewide referral criteria apply to public hospitals and health services only. They do not apply to private hospitals.