Anaemia

ADULT

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Severe anaemia (Hb <70g/L) with risk of cardiovascular and/or syncopal collapse
    • Anaemia associated with definite clinical features of overt gastrointestinal bleeding e.g. haematemesis or melena
    • Severe cytopaenias if patient is unwell (i.e. infection, symptomatic anaemia, active bleeding)
      • Neutrophils < 0.5x109/L
      • Haemoglobin < 70g/L
    • Platelets < 20x109/L
    • Refer to local HealthPathways or local guidelines
    • If dietary cause suspected, modify diet and/or refer to a dietitian
    • If appropriate, treat with supplements (e.g. iron, vitamin B12, folate)
    • An oral supplement should be trialled for at least three months before treatment failure is considered
    • Cease any aggravating medications if possible (e.g. NSAIDS)

    Please note that an Iron deficiency CPC has been developed by Gastroenterology.

Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)

Referrals for anaemia or iron deficiency may be directed to General Medicine, Haematology, or Gastroenterology, depending on the clinical presentation and suspected underlying cause. Referrals will be triaged to the specialty most appropriate to the dominant clinical features and anticipated diagnostic or therapeutic requirements:

  • General Medicine for patients with multisystem comorbidity, complex medical presentations, or where anaemia is part of a broader medical condition requiring comprehensive assessment.
  • Haematology for suspected primary haematological disorders, unexplained cytopenias, abnormal blood indices, or anaemia refractory to initial management.
  • Gastroenterology for patients with suspected or confirmed gastrointestinal blood loss, iron deficiency suggestive of gastrointestinal pathology, or where endoscopic investigation is anticipated.

Where there is diagnostic uncertainty, referrals may be accepted by the most clinically appropriate service and redirected following initial assessment to ensure timely access to definitive care.

  • Refer to General Medicine when anaemia is mild to moderate or when the underlying cause is unclear or multifactorial
  • Symptomatic anaemia (Hb<80g/L) without high risk features or suspicion of hematologic disease
  • Anaemia associated with symptoms such as weight loss, fever, night sweats, or bone pain, where malignancy is suspected but the underlying source is not yet defined.
  • There are multiple comorbidities complicating iron deficiency management.
  • The cause is unclear and does not meet the criteria for Gastroenterology or Haematology referral.
Category 2
(appointment within 90 calendar days)
  • Refer to General Medicine when anaemia is mild to moderate or when the underlying cause is unclear or multifactorial
  • Persistent unexplained mild to moderate anaemia (Hb 80-110g/L)
  • Anaemia refractory to iron or B12 or folate supplementation
  • Anaemia associated with chronic disease or multiple comorbidities requiring coordinated management
Category 3
(appointment within 365 calendar days)
  • No category 3 criteria

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • 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

2. Essential referral information Referral will be returned without this

  • Details of relevant signs and symptoms
  • Details of all treatments offered and efficacy
  • Relevant medical history, co-morbidities
  • Supplementation history, particularly dose and duration of oral iron, B12 and/or folate supplementation
  • Duration of anaemia (if known)
  • Medication history including over the counter (OTC) and complimentary medications (especially NSAIDS, aspirin, corticosteroids, immunosuppressants, antiplatlets and anticoagulants)
  • FBC, ELFTs, ESR, TSH, iron studies

3. Additional referral information Useful for processing the referral

  • Serial FBC results (if available)
  • Serum soluble transferrin receptor assay (if available)
  • History of alcohol and drug use
  • History of menorrhagia
  • CRP, Coombs test or haptoglobin, coeliac serology, intrinsic factor antibody results
  • Vitamin B12 & folate results (if indicated)

4. Request

  • Patient's demographic details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring practitioner details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    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
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • 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
    • 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.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.

    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.

    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 28 September 2026

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