Complex or undifferentiated medical problems


If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

Complex or undifferentiated medical problems

  • Any sudden decompensation in clinical condition that carries risk of serious adverse events or death
  • Pyrexia of unknown origin with temp ≥ 39ºC
  • Pyrexia with neutropaenia
  • Delirium
  • Suspected systemic vasculitis associated with symptoms, signs or investigation results suggestive of vital organ involvement
  • Suspected temporal arteritis (giant cell arteritis) with markedly elevated ESR (>100) and/or jaw claudication and/or visual disturbance

Complex paediatric patients transitioning to adult services

  • Any sudden decompensation in clinical condition that carries risk of serious adverse events or death


  • Any condition defined by other CPCs as requiring referral to emergency
Other Useful Information
  • Laboratory tests should be limited and dependent on the history and examination.
  • Available depression tools include:
    • PHQ-2 – 2 question screening tool
    • K-10 – 10 question screening tool
  • Consider referral to dietitian if significant weight loss reported.
Minimum Referral Criteria

Does your patient meet the minimum referral criteria? 

Category 1
(appointment within 30 calendar days)
Unstable co-morbidities which require early medical intervention to prevent further deterioration that may result in emergency hospitalisation
  • Recent discharge from hospital or emergency department (<4 weeks) and need for ongoing surveillance and optimisation of co-morbidities
  • Acute exacerbation of chronic medical condition which impacts on other co-morbidities and requires close monitoring
  • Rapidly progressive or recent onset of undifferentiated syndromes (eg pyrexia [T<39°C] of unknown origin, marked decline in cognitive function, generalised sub-acute myalgia/arthralgia or other undifferentiated rheumatic syndromes, generalised lymphadenopathy) for which definitive diagnosis and/or management plan is required
  • Fatigue lasting more than 3 months and any of the following:
    • significant weight loss (≥5% body weight in previous 6 months)
    • recent and/or progressive onset in previously well, older patient
    • dyspnoea or other features suggestive of cardiorespiratory compromise
    • unexplained lymphadenopathy
    • presence of fever
Category 2
(appointment within 90 calendar days)
Stable co-morbidities that require risk assessment and medical optimisation
  • Stable or slowly progressive undifferentiated syndromes (eg fatigue, decline in cognitive function, generalised lymphadenopathy) for which definitive diagnosis and/or management plan is required
  • Chronic symptoms (eg dyspnoea, dizziness, imbalance) or condition requiring investigations and management to minimise long term impairment
  • Chronic symptoms causing significant social/economic/functional impairment
  • Diagnostic dilemmas requiring further investigation or confirmation
  • Connective tissue disease which is active but not life threatening
  • Polymyalgia rheumatica (PMR)
Category 3
(appointment within 365 calendar days)
  • Multiple co-morbidities in need of regular review where referral to two or more specialty clinics imposes an unacceptable burden on patients
  • Soft tissue rheumatism
  • Non-progressive fatigue lasting longer than 3 months that remains unexplained despite detailed investigation

If your patient does not meet the minimum referral criteria

  • Consider other treatment pathways or an alternative diagnosis
  • If you still need to refer your patient:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
    • Please note that your referral may not be accepted or may be redirected to another service
Standard Referral Information

Patient's Demographic Details

  • Full name (including aliases)
  • Date and country of birth
  • Residential and postal address including whether patient resides at an aged care facility
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Name of delegate and contact details (Department of Corrective Services)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Relevant clinical information about the condition

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • All conservative options that have been pursued unsuccessfully prior to referral
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
  • Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

Reason for request

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

Clinical modifiers

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living functioning – low/medium/high
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

Other relevant information

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc

Essential referral information

Without this information the referral will be rejected

  • General referral information
  • Relevant medical history, co-morbidities (including depression and anxiety) and medications (including an assessment of adherence)
  • Details of all treatments offered and assessment of efficacy
  • A clear indication of clinical question that the specialist is required to address
  • Details of any functional decline or cognitive impairment
  • FBC, ELFT, ESR & TSH results

In cases of suspected malignancy, pyrexia of unknown origin or generalised lymphadenopathy, also include:

  • CT scan chest/abdomen/pelvis
  • ANA plus full antibody profile if ANA > 1/640
  • Serum protein electrophoresis

In cases of myalgia/arthralgia, also include:

  • CPK results
  • ANA plus full antibody profile if ANA > 1/640

In cases of poorly controlled diabetes, also include:

  • HbA1c

In cases of suspected rheumatological or systemic inflammatory conditions, also include:

  • CRP, Rh factor & ANA results

In cases of suspected or known cardiorespiratory disease, also include:

  • CXR

In cases of unexplained fatigue of recent onset, also include:

  • Impact on daily life and work (including falling asleep while driving)
  • CXR
  • Urinalysis results
  • Calcium, ESR/CRP, iron studies, CPK (if muscle weakness or pain), vitamin B12 & folate results
Additional Referral Information
  • Existing psychosocial issues and supports
  • Copies of discharge summaries and outpatient letters relating to encounters with other specialists
  • ECG
  • BNP (if available)
  • Magnesium and phosphate results (if appropriate)
  • Documentation relating to past hospitalisations and clinic visits for anxiety/depression (if appropriate)
  • Background information on occupational history and past infectious diseases (if appropriate)
Clinical Override

Clinical override of referral criteria may be requested in the following situations:

  • Inability to include essential referral information. If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons.
  • Patient does not meet minimum referral criteria. If the patient does not meet the criteria for referral but the referring practitioner believes that the patient requires specialist review.
  • Presence of clinical modifiers. The presence of clinical modifiers (as listed above in Standard referral information) may impact on the categorisation of a patient.

Include the reason for request for clinical override as part of the referral. Referrals are reviewed by the triaging specialist who determines the most appropriate course of action.

Out of catchment

West Moreton Health is responsible for providing a public health service to people who reside within its catchment area. To appropriately manage demand for service we do not accept referrals from outside this catchment area. If your patient does live outside the West Moreton Health area and it is deemed socially or clinically necessary for their care to be received in the West Moreton Health Service, inclusion of information regarding their particular medical and/or social factors will assist with the triaging of your referral.


To provide feedback about contents on this website or general referral questions please email or phone 3413 7402.