In order for us to be able to accept your patient for review and treatment, referring GP’s/Medical Specialists are required to provide the following detail in your referral.
- date of referral
- requested clinic colorectal
- name of specialist to whom the patient is being referred (for MBS-billed clinic).
- presenting problem and duration of symptoms
- GP diagnosis or provisional diagnosis, if known
- relevant medical history
- relevant social history or special needs
- current medications
- required investigation results
- allergies or warnings
- physical examination results
- management to date and response to treatment.
Investigations and results
Referral reason and required investigations (essential with referral)
Acute mild diverticulitis
- recent FBE; ESR; LFT’s,
- abdominal ultrasound
Recent changes in Bowel habits
- recent FBE; U&E’s; ESR; TFT’s, LFT’s
- stool sample
- AXR +/- CT Abdo/pelvis (where appropriate)
- ? PSA test.
Palpable mass on rectal examination
- recent FBE; U&E’s; ESR; LFT’s;
- possible colonoscopy.
Asymptomatic bloody stools
- recent FBE; U&E’s;
- recent stool sample
- bowel chart.
Unexplained weight loss
- recent FBE;U&E’s; LFT
- abdominal ultrasound +/- X-ray.
Colo-vesical or colo-vaginal fistula
- recent FBE; U&E’s Lipid profile.
- PR examination findings.
Anal fistula/ fissures
- recent LFT; U&E;
- PR examination findings
Suspected colo-rectal cancer
- any urgent cases refer to the emergency department
- recent FBE, U&E
- abdomen ultrasound
- recent examination.
- blood tests – FBE, ESR, U&E’s, CA, LFT’s, FE, TFT’s, immunoglobulins.
Benign anal polyps
- rectal examination findings.
- rectal examination findings.
Please address the referral to Werribee Mercy Colorectal Clinic and fax to the Outpatient Department on 03 8754 6710.
Essential referral content will be checked. You will be contacted if further information is required.
Acknowledgement of referral receipt will occur within eight working days.
The referral will be triaged by the specialist areas according to clinical urgency.
This determines how long the patient will have to wait for an appointment.
Patients with urgent conditions are scheduled to be seen within 30 days.
Patients with non-urgent conditions are given the next available appointment according to clinical need.
Both the referrer and patient are notified.
Immediate assessment criteria
Immediate assessment or admission criteria (not an exhaustive list)
Step 1: Check criteria for immediate assessment or admission.
- diverticulitis with systemic sepsis
- large bowel obstruction
- severe PR bleeding
- confirmed or suspected colorectal cancer
- acute pain or undiagnosed symptoms
- conditions not fitting the category 1 criteria
Step 2: Contact the Emergency Department Admitting Officer via the switchboard: 03 8754 3000.
Step 3: Refer the patient to the Emergency Department. All urgent cases needs to be sent via MIA.
The clinical information provided in your referral will determine the triage category. The triage category will affect the timeframe in which the
patient is offered an appointment.
If the condition requires immediate assessment or admission a referral to the Emergency Department (ED) should be attended to. Please refer the patient to the ED for clinical review. Referrals for urgent review in the ED should be addressed to the Emergency Department.
Urgent (seen within 30 days of referral receipt)
The patient has a condition that has the potential to deteriorate quickly with significant
consequences for health and quality of life if not managed promptly. Examples
• Positive FOBT – Refer to the Rapid Access Colonoscopy Clinic
• Acute mild diverticulitis
• Recent changes in bowel pattern
• Mass palpable on rectal examination
• Asymptomatic bloody stools
• Unexplained weight loss
• Colo-vesical or colo-vaginal fistula
Non-urgent (seen within 365 days of referral
receipt as clinically indicated)
The patient’s condition is unlikely to deteriorate quickly
or have significant consequences for the person’s
health and quality of life if specialist assessment is
delayed beyond one month. Examples:
• Low risk PR bleeding
• Visible haemorrhoids, palpable fistula on PR
• Bright blood on examination
• Fistulas or fissures uncomplicated
• Routine follow-up on IBD
• Diverticula or disease for follow-up
Referral contact details
Werribee Mercy Hospital – Outpatient Clinics
300 Princes Highway,
Werribee Vic 3030
Phone 03 8754 6700
Fax: 03 8454 6710
Clinics and services
Use these guidelines to refer patients for the following clinics and services:
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