Vascular outpatient services in CALHN

The Vascular Surgery service for Central and Northern Adelaide is based at the Royal Adelaide Hospital (RAH), but consults and operates at several sites across the SA Health local networks based on disease complexity and patient needs.  We aim to provide care as close to the patients home as possible.

ALL referrals are triaged based on clinical priority and nearest hospital appointment availability.  Please advise patients at the time of referral that the site at which they are seen may vary depending on their urgency.

Referrals

All referrals are triaged by the service according to clinical urgency. Patients who are unstable and require immediate assessment should be sent directly to the nearest Emergency Department. 

To make a referral 

To refer your patient, follow the outpatient service information, triage and referral guidelines, complete and fax a referral to us. For urgent referrals, also contact the registrar on call to discuss the case. Our registrars are on call 24 hours a day 7 days a week on the enquiries telephone number below.

To ensure appropriate and timely triage, include all demographic and clinical details as well as relevant investigation results.  

Referral — Fax: (08) 7074 6247
Enquiries — Phone: 1300 153 853 

If you are concerned about any delay of the appointment or if there is any deterioration in your patient’s condition, telephone the Registrar/Fellow on-call via the RAH switchboard: (08) 7074 0000

GP Information

Consulting specialists

  • Dr David King - Head of Unit Royal Adelaide Hospital (RAH) Vascular Unit
  • Dr Ewan Macaulay - RAH, Llyell McEwin Hospital (LMH) (sclerotherapy only) 
  • Dr Michael Herbert - RAH, The Queen Elizabeth Hospital (TQEH), LMH, Murray Bridge and Whyalla
  • Dr Kurian Mylankal - RAH, Modbury, LMH and Wallaroo
  • Dr Joseph Dawson - RAH, TQEH and Port Lincoln
  • Dr Conor Marron – RAH, LMH and Gawler
  • Professor Fitridge - TQEH
  • Dr Peter Subramaniam - TQEH 
  • Dr Sharon Hong — RAH and TQEH

Foot clinics

Multidisciplinary Foot Clinics are held at RAH, LMH & TQEH to assess people with complex diabetic foot issues with combinations of biomechanical, neuropathic, ulceration, infection and ischemia. 

Referrals can be faxed to the Allied Health departments RAH/TQEH Fax (08) 7074 6247 or LHN Fax (08) 8182 9440

For all enquires please contact the podiatry department of the relevant hospital; out of hours calls can be directed to Vascular on-call via RAH switchboard (08) 7074 0000

Clinical information

Claudication

  • Please note that all claudicants should be advised to stop smoking, and commenced on both a statin and antiplatelet agent before referring for review.
  • We also provide Claudicant Rehab program to assist in improving symptom management at the RAH. Transport for this clinic is at the patient’s own expense.  If you patient is interested in this please state this in your referral.

Varicose veins

  • A Venous duplex scan confirming the above criteria should also be provided at the point of referral. Inappropriate referrals will be declined for treatment in public health and will not be offered an appointment.
  • Compression hosiery can be initiated in patients without arterial issues for pain and discomfort at the patient’s expense in the community as long as an ABI has been completed prior to commencement.

Lymphoedema

  • Lymphoedema management without ulceration is best managed by the physiotherapy Departments at TQEH & LMH.  Please direct any lymphedema referrals directly to the Allied Health Department (TQEH) Fax (08) 8222 6621 or (LMH) Fax (08) 8182 9440.

Health Pathways

Health Pathways South Australia is an online portal designed to be used by general practice at the point of care to guide best practice assessment, management and referral of common clinical conditions.

Vascular clinical information sheets

The following information sheets about presentations commonly seen in vascular outpatients provide the minimum information required for assessing a referral under the headings of: eligibility, priority, differential diagnosis, clinical information and investigations required, pre-referral management strategies and discharge criteria.

Patient Information

To access these clinics — you will need a referral from your GP

Your doctor will need to fax your referral letter to us. We will be in contact with you within clinically recommended times, depending on waiting list length. If there is no waiting list, you will receive an appointment booking letter or we will contact you to arrange a suitable time.

Please refer to the information sheets below for information regarding the outpatient service.

CALHN Vascular remote surveillance program

The CALHN Vascular Surgery service provides a centralised remote surveillance program.

This program provides a service for patients who do not have a clinical need to attend the outpatient department for review but do require ongoing imaging for either established vascular disease or following vascular intervention.

The program is managed by a full time vascular nurse under the supervision of consultant vascular surgeons.

Clinically stable patients are offered enrolment into the program by their treating consultant and can elect to be monitored by remote review of surveillance imaging (usually Duplex ultrasound) in lieu of routine outpatient clinic appointments after the scan is performed.

  • The clinician may recommend an imaging provider at the time of enrolment. This may be the closest provider to the patient’s home, or a provider who has specialty skills in vascular ultrasound imaging. The specialist vascular ultrasound providers (Vascular Ultrasound partners, Adelaide Vascular and SA Medical Imaging) bulk-bill all studies. Other private radiology providers may or may not bulk-bill the patient. Any financial interests of the surgeon e.g ownership of the scanning practice will be disclosed to the patient when selecting the scanning location.
  • The general practitioner is advised of each patient’s enrolment into the program and is regularly updated with imaging reports.
  • Clinical review in the vascular outpatient department is organised by the surveillance nurse if there are any concerns noted on routine imaging.

For General Practitioners and Primary Health Care Clinicians

If your patient is currently enrolled in the vascular remote surveillance program and you have any concerns regarding their surveillance please contact the Vascular Surveillance Clinical Nurse on either telephone: (08) 7074 2511 or email Health.RAHVascularRemoteSurveillance@sa.gov.au