Bay of Plenty

Find the referral acceptance and access criteria for vascular surgery in the Bay of Plenty.

Referral acceptance

Referral acceptance

Vascular referrals are prioritised by senior medical officers based on the information contained within. Additional information should be attached where available. The prioritisation tool used to triage referrals can be found below under access criteria.

All accepted referrals will be seen within a maximum waiting time of 4 months, unless there is a clinical reason for delay.

Referral acceptance is a follows:

First specialist assessments

Wait times

Waiting priority 1

Accepted

Waiting priority 2

Accepted

Waiting priority 3

Accepted

Waiting priority 4

Declined


At first specialist assessments (FSA), patients are assessed by a specialist and if surgery is required, patients are then prioritised using the National CPAC tool.  A 0-100 score is allocated to each patient.

Prior to acceptance for surgery, patients are assessed in an anaesthetic pre-assessment clinic to ensure they are fit for surgery.

All patients accepted for surgery will be treated within a maximum waiting time of 4 months, unless there is a clinical reason for delay.

All vascular surgery is done at Tauranga Hospital.

Surgery acceptance is as follows:

Treatment list

Waiting priority 1

Accepted

Waiting priority 2

Accepted

Waiting priority 3

Accepted

Access criteria

Access criteria

Prioritisation tool for other general surgical and vascular referrals:

Category

Criteria

Examples (not an exhaustive list)

1. Urgent/FCT
(within 2 weeks)
  • High risk life or limb.
  • Major deterioration or exacerbation with delay.
  • Otherwise requiring acute admission.
  • Pressing other or "psychosocial" factors.
  • Symptomatic or obstructing colon cancer.
  • Vomiting and gastric outlet obstruction.
  • Breast cancer/young distraught patient.
  • Diabetic foot sepsis or gangrene.
  • Obstructive jaundice.
  • Crescendo TIA/carotid stenosis.

2. Semi-urgent
(within 4-8 weeks)
  • Proven or likely malignancy (not BCC).
  • Alarm symptoms or signs malignancy.
  • Frequent severe painful or disabling conditions.
  • Significant short or medium term risks.
  • Hx severe complicated cholelithiasis e.g. biliary pancreatitis.
  • Hx obstructed inguinal hernia.
  • Palpable rectal mass.
  • Suspicious breast lump.
  • FNA +ve ear and neck lump.
  • Elderly iron deficiency anaemia.
  • Ischemic rest pain or nocturnal leg hanging.
  • Large AAA.

3. Non-urgent
(within 4 months)
  • Occasional or moderate pain only.
  • Persisting minor disability or loss of function.
  • Non-specific symptoms or signs +/- low risk demographic requiring investigation.
  • Low grade sepsis.
  • Mild symptoms cholelithiasis.
  • Fistula-in-ano.
  • IBS symptoms/young adult.
  • GORD/dyspepsia/young adult.
  • Anal outlet bleeding/young adult.
  • Venous ulcer disease.
  • Chronic pilonidal disease.
  • Intermittent claudication.
  • Non-specific breast symptoms/mastalgia.
  • Re-excision melanoma surgery.
4. Routine
(Not accepted)
  • Minimal functional impairment.
  • Likely benign.
  • Chronic or stable.
  • Little short to medium term risk.
  • Significant family history.
  • Minor or nil loss of function.
  • Minor or nil discomfort.
  • Benign or low grade malignant.
  • Self-limiting.
  • Low risk.
  • Asymptomatic carotid disease.
  • Non-specific vascular symptoms.
  • FAP screening.
  • Asymptomatic hyperPTHism.
  • Haemorrhoids.
  • Gynaecomastia.
  • Small AAA.
  • Epitheliomata.
  • Chronic goitre.
  • Uncomplicated hernia.
  • Lipoma.
  • Seb cyst.
  • Cosmetic (scars or tattoos).
  • Ganglion.
  • Low risk "screening".
  • Skin tags.
  • Minor BCC/SCC surgery.

Notes

  • “Clinical Priority” criteria are a guide rather than exhaustive, complete or exclusory. The grading surgeon may well take into account other factors such as comorbidity, age, history and previous investigation results to help prioritise a particular referral. The examples similarly are not necessarily prescriptive e.g., an elderly patient with severe ischemic heart disease and claudication may have a different priority from a postman with similar symptoms. 
  • Simple skin cancers are not considered “urgent” malignancies.
  • Varicose veins if meet primary care management guidelines
  • The waiting time criteria are to be seen as a guide to maximum wait. If patients cannot be seen within time, then the referrer will be notified by administrative staff.