If you believe your patient requires immediate attention please phone 000 or refer your patient to the emergency department.
- Nil minimum referral requirement
Patient's Demographic Details
- Full name (including aliases)
- Date and country of birth
- Residential and postal address including whether patient resides at an aged care facility
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Name of delegate and contact details (Department of Corrective Services)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
- Any special needs, access requirements and/or disability relevant to the referral
Referring Practitioner Details
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
- Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner
Relevant clinical information about the condition
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- All conservative options that have been pursued unsuccessfully prior to referral
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
- Any special care requirements where relevant (e.g. tracheostomy in place, oxygen required)
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
Reason for request
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can't order, or the patient can't afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
Clinical modifiers
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living functioning – low/medium/high
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
Other relevant information
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
Without this information the referral will be returned
This is not a CPC guideline. West Moreton staff please select 'CPC not applicable'
Antenatal screening |
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Antenatal screening |
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Pasifika and Refugee Liaison Clinical Midwives
West Moreton has new Liaison Clinical Midwives for women from Pasifika and Refugee/CALD backgrounds.
The Liaison Clinical Midwives can provide women with information on what services are available, and how to access these services. They also work with multidisciplinary healthcare providers to plan culturally responsive care. Pregnant women can contact the Liaison Midwives directly, or be referred when they book-in for antenatal care.
Community Antenatal Clinics have commenced at Redbank Plains Community Centre and Goodna Community Health Centre.
Contact :
Pasifika Liaison Midwife Natalie Poole 0436 917 386
Refugee Liaison Midwife Jac Matyear 0436 926 053
What is No Buts for Bub?
No Buts for Bub is an 8-week social and emotional wellbeing program for Aboriginal and Torres Strait Islander pregnant women which caters to the unique social and cultural needs of Aboriginal and Torres Strait Islander pregnant women. The program focuses on a holistic health approach to health. Each of these women access support for their physical health through our antenatal services, this program aims to provide support for the social, emotional, spiritual and cultural elements of health.
The program includes one on one consultations for social support and advocacy with our Aboriginal Health Worker (infant and maternal) and the Indigenous Hospital Liaison Officer (Maternity), and weekly yarning circle topics with cultural activities.
The aim of the program is to provide cultural, social and emotional support to Aboriginal and Torres Strait Islander women throughout their pregnancy.
The program will run weekly on Fridays from May - June 2019.
Transport and lunch will be provided.
The venue is Redbank Plains Community Centre, 180 School Road Redbank Plains.
Participant requirements include:
- Identify as Aboriginal and/or Torres Strait Islander
- Less than 6 months pregnant at time of program commencement
- Resident of West Moreton region
- Plans to birth at Ipswich Hospital
The cultural activities will include weaving, beading, cooking and painting workshops. All participants will get to paint their own belly cast to keep as a keepsake.
Young children are welcome to come along as the venue has toys and parent room.
Participants are welcome to bring a female support person along with them.
Participants receive baby bags which are filled with one small gift each week they participate.
To ensure we can evaluate the program accurately it is preferred that participants attend the 8 sessions.
To refer someone to this program please click here
- Chlamydia investigation for patients 25 years or under
- Dating and Morphology Ultrasound scans
- Aneuploidy screening
- GTT for selective high risk patients
Clinical override of referral criteria may be requested in the following situations:
- Inability to include essential referral information. If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons.
- Patient does not meet minimum referral criteria. If the patient does not meet the criteria for referral but the referring practitioner believes that the patient requires specialist review.
- Presence of clinical modifiers. The presence of clinical modifiers (as listed above in Standard referral information) may impact on the categorisation of a patient.
Include the reason for request for clinical override as part of the referral. Referrals are reviewed by the triaging specialist who determines the most appropriate course of action.
Out of catchment
West Moreton Health is responsible for providing a public health service to people who reside within its catchment area. To appropriately manage demand for service we do not accept referrals from outside this catchment area. If your patient does live outside the West Moreton Health area and it is deemed socially or clinically necessary for their care to be received in the West Moreton Health Service, inclusion of information regarding their particular medical and/or social factors will assist with the triaging of your referral.
Feedback
To provide feedback about contents on this website or general referral questions please email WM-CPC@health.qld.gov.au or phone 3413 7402.