Clinical Prioritisation Criteria

Background

SA Health’s initial focus is to invest in reducing waiting times so accessing outpatient appointments is easier, more transparent, and more effective. Through collaboration with a number of clinicians across SA, the Outpatient Redesign Project aspires to create sustainability in improved access to services, transparency, governance and accountability.

One of the initiatives is to develop consistent and publicly available Clinical Prioritisation Criteria or CPC.

The CPC are clinical decision-making support tools that assist in ensuring patients referred are clinically categorised and accepted based on standardised statewide clinical referral criteria.

Benefits

The CPC will help to ensure the public and health professionals have consistent, accurate and standardised information available regarding referral criteria and urgency categorisation for each specialty, along with what tests and diagnostics need to be performed prior to referral.

The development of CPC will result in improvements in the quality of referrals, reduce inappropriate referrals, support diagnostic testing to be completed prior to referral to a hospital specialist and better define clinical pathways across the state. This will assist in providing patients with the best health care available to meet their health needs.

For further information see the  overview presentation (PDF 548KB)

Aims

The CPC aims for:

  • transparency of outpatient criteria between Local Health Networks (LHNs), primary care and the public
  • health professionals to be enabled with accurate and consistent speciality referral criteria and diagnostics required to support patient focussed decision making
  • patients to have accurate and consistent referral criteria and categorisation to improve their health literacy and enable informed decision making
  • equitable assessment of patients regardless of where they live
  • specialist outpatient appointments to be delivered in order of clinical urgency
  • patients who are ready for care at their first specialist outpatient appointment
  • referral and communication process improvements between referrers (e.g. primary care) and specialist outpatient services
  • increased referral quality by LHNs being transparent in the information and diagnostics required to support timely access to the most appropriate care.

CPC previously consulted on

Consultation on following CPC have now closed. The final CPC for these specialities will be released in early 2022.

  • Cardiology
  • Ear, Nose and Throat
  • Gastroenterology 
  • Neurology
  • Orthopaedics
  • Vascular

Acknowledgement

SA Health would like to acknowledge the valuable contribution of SA Health staff and primary care clinicians during the development of CPC. We would also like to recognise the use of reference material from state, interstate and international sources throughout the development of CPC.

Further information