Criteria for referral to public hospital service

Persistent cough (> 8 weeks) with normal chest x-ray and normal pulmonary function and where any of the following explanations have already been excluded:

  • asthma
  • chronic obstructive pulmonary disease (COPD)
  • chronic rhinosinusitis
  • gastroesophageal reflux
  • hoarse voice (dysphonia)
  • hypersensitivity or sensitivity to environmental irritants (e.g. perfumes and bleaches)
  • lung cancer
  • medicine induced cough (e.g. ACE-inhibitors, angiotensin-II receptor antagonist)
  • respiratory infection
  • smoking (cigarettes and all forms of tobacco, nicotine, vaping and cannabis).

Information to be included in the referral

Information that must be provided

  • Symptoms including duration, severity, any diurnal variation and associated syncope and incontinence
  • Findings on physical examination, including oxygen saturation
  • Details of previous management including the course of treatment(s) and outcome of treatment(s)
  • Any known or suspected allergies or triggers
  • Smoking history (cigarettes and all forms of tobacco, nicotine, vaping and cannabis)
  • History of occupational or environmental exposure risks, or radiotherapy treatment (if relevant)
  • Chest x-ray (including date and details of the diagnostic imaging practice)
  • Recent (in previous 6 months) full blood examination (FBE) results
  • Erythrocyte sedimentation rate (ESR)
  • Current and complete medication history (including non-prescription medicines, herbs and supplements)
  • Past medical history and comorbidities.

Provide if available

  • Spirometry
  • Other lung function tests
  • High resolution chest CT (including date and details of the diagnostic imaging practice)
  • Details of any previous gastroenterology or ENT assessments or opinions
  • Previous gastroscopy findings.

Additional comments

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

Referrals for assessment of asthma management or suspected or confirmed chronic obstructive pulmonary disease should be directed to a respiratory service provided by the health service.

Referrals for gastroesophageal reflux should be directed to a gastroenterology service provided by the health service.

Referrals for hoarse voice (dysphonia) or rhinosinusitis should be directed to an ENT service.

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

Referral to a public hospital is not appropriate for

Referrals that do not meet the criteria.