For Clinicians:
1. The orthopaedics department is now receiving the majority of their referrals through e-referrals. Please communicate through this medium as much as possible in order to streamline the triage and booking process.
2. Keep in mind that most rejected referrals are due to a lack of information
3. Please include current medications, tests, labs, x-rays (within the last 2 months) and ultrasound reports, all relevant private specialist’s reports and ACC number with your referral. This will expedite the process to have a patient seen and a decision made quickly about the best course of treatment.
4. The GP/ referrer can choose 1 of 4 options when referring to Orthopaedics namely:
-Fracture Clinic
-Spine
-Soft tissue lump/Bony tumor and
-Limb
5. Please refer to the updated Health Pathway for soft tissue lumps in adults Soft Tissue Lumps in Adults (also under document downloads).
All referrals need results of ultrasound and XR to enable prompt triage of the referral.
6. If the patient has a High suspicion of cancer/confirmed cancer please mark the referral urgent to prioritize triage.
7. Spinal referrals: Kindly note the completed spine questionnaire needs to be attached to the e-referral, is an essential triage tool to all spinal referrals enabling prompt triage of the referral resulting in timely review of the patient. Hence significantly decreasing delays in the triage process and clinic review.
Unfortunately, if this is not completed and returned then their referral will be suspended.
• The questionnaire for NECK pain is found here.
• The questionnaire for LOW BACK pain is foiund here.
8. If your patient has an ACUTE orthopaedic condition eg septic joint/ osteomyelitis/fracture please discuss with the On call Orthopaedic registrar as there is no ability see patients acutely when referred to Orthopaedic outpatients
9. If you are referring a patient for an acute admission/review use the Acute Admission template only, NOT use the ‘urgent’ option on the eReferral template to send in an Acute Admission
10. Thank you for your ongoing care in optimizing your patients medically to ensure” fitness for surgery” resulting in timeous Orthopaedic surgery to meet patient’s expectations and decrease post-operative morbidity from elective surgery.
• For patients with hypertension and/or diabetes, aim for BP<140/90 and HbA1C is ideally between 50-55.
11. If ACC, consider referral to private sector for TIMELY treatment (if clinically appropriate).
For Patients:
1. Referral by General Practitioner
You will need to be assessed by your GP who can then refer you to the Orthopaedic Department at the Auckland Hospital (Greenlane site). During your GP visit, ensure that adequate information is provided to the GP so that they can make an appropriate referral. Kindly, remind your GP to order the necessary investigations and attach them to your referral in order to avoid delays.
2. Contact Details
Please ensure you give your GP your CURRENT CORRECT CONTACT details so that you may be contacted for your appointment. If you have moved house, remember to change your contact details. You will be contacted on your cellphone so please respond to messages on your phone. If we cannot contact you, we are not able to give you an appointment to see the orthopaedic surgeon.
3. Triaging of referrals
There are currently more requests for appointments than we have the capacity to see, therefore, referrals are prioritised according to greatest need. We see the most urgent and the most disabled patients. Patients with lesser levels of disability, whose referral is declined, will need to pay privately see a doctor outside the public hospital system. If you have health insurance, you may be able to consult an orthopaedic surgeon in the private sector in a timely manner.
Many minor orthopaedic conditions are treated well by GPs. Alternatively, your doctor may recommend that you will receive swifter and more effective treatment by referring you to a sports medicine doctor, a rheumatologist, or a physiotherapist. For many minor orthopaedic conditions these are exactly the same health professionals that the orthopaedic surgeon uses to assist in your recovery.
4. Appointment to see an orthopaedic surgeon
There are some conditions that only an orthopaedic surgeon can treat and if your GP refers you to the Orthopaedic Department, you may be given an appointment to see a specialist surgeon. In this case the hospital will write to you giving you an appointment time and date. There may be some delay before you receive one. The current wait time is a maximum of four months.
5. Attend your outpatient appointment in Greenlane Clinical Centre
Sometimes you may be requested to have imaging e.g. CT and MRI prior to seeing the orthopaedic surgeon. The imaging is necessary to help the specialist manage your condition. If you require an MRI and are claustrophobic, please inform your GP so the GP can prescribe medication to help with that for your procedure. MRI and CT are high cost procedures. Please attend your appointments. If you cannot go, make contact with Greenlane Clinical Centre to cancel or change your booking. This way, we can ensure another patient can make use of your appointment time.
If you wish to read more about the process of elective service provision as outlined by the Ministry of Health, please click here
6. What you can do to “GET FIT” for your Orthopaedic surgery:
- If you have hypertension and/or diabetes, see your GP to assess and ensure your BP and diabetes is well controlled. Aim for a BP<140/90 and HbA1C is ideally between 50-55.
- Participate in rehabilitation as advised by your orthopaedic surgeon and physiotherapist.
Urgent referrals
If you have an urgent orthopaedic condition such as a bone infection, present at the Auckland Hospital emergency department for treatment. If you have a malignant bone tumour, your doctor will mark the referral Urgent.
Injuries covered by Accident Compensation Corporation (ACC)
If you have a condition that was caused by an accident, we are able to treat you at ADHB. Please bring your ACC number with you to appointments if you have been given one. You may also decide to receive assessment and treatment from an orthopaedic surgeon outside the hospital.
