Criteria for referral to public hospital service

• Identified osteoarthritis of the shoulder with ongoing moderate or severe pain or functional impairment, or both, despite at least six months of treatment that has included targeted education, physiotherapy (if tolerated) and medication.

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
• Findings on physical examination 
• Description of joint affected and onset, nature and duration of symptoms
• How symptoms are impacting on daily activities including impact on work, study or carer role and level of sleep disturbance
• Patient age
• Details of previous medical and non-medical management including the course of treatments and outcome of treatments
• x-ray of two views of the affected shoulder: anteroposterior (AP) and lateral
• Current and complete medication history (including non-prescription medicines, herbs and supplements and recreational or injectable drugs).

Provide if available

• Details of any previous joint surgery, including when and where procedures were performed
• Statement about the patient’s interest in having surgical treatment if that is a possible intervention
• If the person identifies as an Aboriginal and 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.
Ultrasound imaging is not indicated, and MRI scans are not required if osteoarthritis is shown on x-ray.
There are other statewide referral criteria that include reference to shoulder pain:

• Inflammatory arthritis 
• Shoulder trauma
• Non-traumatic shoulder conditions
• 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

• Osteoarthritis of the shoulder where at least six months of treatment that included targeted education, physiotherapy (if tolerated) and medication has not been trialled.