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Orthopaedics

Referral Acceptance

Orthopaedic referrals are prioritised by Senior Medical Officers based on the information contained within. Additional information should be attached where available. The priorisation tool used to triage referrals can be found below under Access Criteria.

All accepted referrals will be seen within a maximum waiting time of 4 months, unless there is a clinical reason for delay.

Referral acceptance is a follows:

First Specialist Assessments

Priority 1

Accepted

Priority 2

Accepted

Priority 3

Accepted

Priority 4

Declined 

Priority 5

Declined 


At First Specialist Assessment (FSA), patients are assessed by a specialist and if surgery is required, patients are then prioritised using the National Orthopaedic CPAC tool.  A 0-100 score is allocated to each patient.

Prior to acceptance for surgery, patients are assessed in Anaesthetic preassessment clinic to ensure they are fit for surgery.

All patients accepted for surgery will be treated within a maximum waiting time of 4 months, unless there is a clinical reason for delay.

Surgery acceptance is as follows:

CPAC 65+

Accepted

CPAC 64 and below

Declined

 

Access Criteria

Category Criteria

Immediate Priority 1 (next clinic)

  • Suspected malignancy
  • New profound neurological deficit
  • Major risk of permanent disability through delay
  • Trauma not requiring immediate intervention
  • Major risk of permanent disability through delay

2 (next available clinic slot) 

  • All paediatric referral
  • Severe functional impairment – requiring considerable assistance ADL, community living at risk
  • Severe pain – sleep regularly disturbed, on maximal analgesic control
  • Employment seriously restricted

3 (4 months)

 

 

  • Moderate functional impairment – some assistance required ADL
  • Moderate pain – sleep disturbance
  • Exhausted non-operative measures, including physiotherapy, lifestyle modification, on modest analgesic control
  • Moderate risk of permanent disability through delay
  • Rapidly progressive deformities
  • Minor cases that have failed non-operative management. ie Carpal tunnels, trigger finger

4

  • Mild functional impairment – mild restriction of leisure activity
  • Mild episodic pain – adequate analgesic control
  • Low risk of permanent disability through delay
  • Employment being maintained

5

  • No/minimal functional impairment
  • No/minimal/episodic pain – analgesics seldom required
  • No/minimal risk of permanent disability through delay