CPAC006

CLINICAL PRIORITY ACCESS CRITERIA

Service Category: GENERAL MEDICINE

/ Patient Type: Outpatient (Assessment)
Category Definitions: / 1. Urgent – Seen within 1 week
2. Semi-urgent – Seen within 1 month
3. Routine – Seen within 2 months
Category /

Criteria

/

Examples

(not an exhaustive list)
1.

Urgent

Seen within 1 week
/ ·  Major clinical risk if assessment/treatment delayed.
·  Severe or rapidly-progressive undiagnosed problem.
·  Uncontrolled, acute and/or severe symptoms and/or major functional impairment.
·  / ·  Severe organ specific disease with or without intercurrent significant other problems eg. RA+ diabetes + COPD.
·  Potentially serious condition requiring diagnosis eg? Malignancy.
Refer to subspecialty criteria and examples.
2.

Semi-urgent

Seen within 1 month / ·  Unexpected deterioration of known condition.
·  Symptoms causing significant social/economic/functional impairment.
·  GP diagnosis probable but further investigation/specialist confirmation required and condition potentially serious particularly if assessment/treatment is delayed.
·  Hospital admission possible if patient is not evaluated promptly. / ·  Unstable diabetes.
·  Chest pain in professional drive falls/syncopal episodes.
·  TIA? Cause
·  Significant abnormal investigation result.
·  Syndrome X (obesity, hypertension, gout, diabetes, heart failure).
Refer to subspecialty criteria and examples.
3.

Routine

Seen within 2 months / ·  Where wait time for specialist will not place the patient at risk of prolonged discomfort nor development of more serious symptoms/disease.
·  Reassessment of known major/complex multisystem disorder. / ·  Chronic stable or slowly progressive condition.
·  Transfer referral from another centre.
·  Previously discharged from General Medical Service (I/P and/or O/P).
Refer to subspecialty criteria and examples.
NOTE:
·  GP’s can enhance referral process for urgent or complex cases via telephone consultation.
·  Supporting communication by E Mail or fax should be considered.
·  Consultant General Physicians, with their breadth of knowledge, direct and co-ordinate the management of unselected or undifferentiated medical problems, particularly complex and multisystem disease. This service usually dominates in provincial centres though may work in parallel within subspecialty acute services in large centres.
·  General Physician practice in nominated subspecialty(ies) should be equivalent to subspecialty practice (though may lack the depth, eg Cardiology being subspecialty nominated, may not be trained in cardiac catheterisation). Peer recognition is expected. Eg. Membership of Subspecialty Society.

Last updated February 2006 Page 2 of 2