Criteria for referral to public hospital service
- Complex non-melanoma skin malignancies and any of the following:
- neurological involvement
- poorly differentiated or infiltrative tumour identified on biopsy
- rapidly enlarging
- ulceration and bleeding
- Other subcutaneous and deep tissue malignancies e.g. Merkel cell carcinoma, sarcoma
- Skin lesions with any of the following:
- causing functional problems (e.g. obstruction of vision)
- causing significant disfigurement
- diagnosis in doubt, or needs confirmation
- diameter greater than or equal to 5cm in size
- fixed to deep tissues
- lesions are prone to recurrent infection
- rapid growth over short period of time
- recurring after a previous excision
- significant persistent pain that is not solely pressure related
Information to be included in the referral
Information that must be provided
- Details of onset, duration, site, size and any recent changes in size of lesion(s)
- Symptoms such as ulceration, bleeding, pain
- Histology results
- History of smoking
- If the patient is taking and anticoagulant medicine
- If the patient is immunocompromised or has a history of immunosuppression
- Statement about the patient’s interest in having surgical treatment if that is a possible intervention.
Provide if available
- Photograph of lesion(s)
- Ultrasound of lesion(s)
- If the person identifies as an Aboriginal and/or Torres Strait Islander
- If the person is part of a vulnerable population.
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.
Most low-risk basal cell carcinomas and squamous cell carcinomas can be managed in primary care and do not require referral to a public hospital specialist clinic.
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
Benign skin lesions not causing functional problems (e.g. causing obstruction to vision), or significant disfigurement and not related to immunosuppression.