Criteria for referral to public hospital service

  • Skin breakdown or infection, or both, secondary to severe contracture
  • Metacarpophalangeal (MCP) joint flexion contracture greater than 30 degrees with functional impairment
  • Proximal interphalangeal (PIP) joint flexion contracture greater than 10 degrees with functional impairment
  • Recurrence of contracture after surgery with functional impairment.

Information to be included in the referral

Information that must be provided

  • Reason for referral and expectation or outcome, anticipated by the patient, or their carer, and the referring clinician from referral to the health service
  • Range of measurement (ROM) measurements
  • Details of functional impairment and how symptoms are impacting on daily activities including impact on work, study or carer role
  • Details of previous medical and non-medical management including the course of treatments and outcome of treatments
  • If referral relates to recurrence after surgery, details of the surgery including when and where procedure(s) were performed
  • History of smoking
  • If the patient is taking an anticoagulant medicine
  • Statement about the patient’s interest in having surgical treatment if that is a possible intervention.

Provide if available

  • If the person identifies as an Aboriginal and/or Torres Strait Islander
  • If the person is part of a vulnerable population.

Additional comments

The Summary and referral information lists the information that should be included in a referral request.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

  • Vulnerable populations include:
    • people from culturally and linguistically diverse backgrounds
    • older Australians
    • carers of people with chronic conditions
    • people experiencing socio-economic disadvantage
    • people living in remote, or rural and regional locations
    • people with a disability
    • people with mental illness
    • people who are, or have been, incarcerated.

Vulnerable patient groups also include terminally ill patients, patients with experiences of family violence, in out-of-home care, foster care and those in state care.

Referral to a public hospital is not appropriate for

  • Palmar thickening or nodules without contracture
  • Contracture without functional impairment
  • Metacarpophalangeal (MCP) joint flexion contracture less than or equal to 30 degrees
  • Proximal interphalangeal joint (PIP) joint flexion contracture less than or equal to 10 degrees.