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Termination of pregnancy

Minimum referral criteria

Termination of pregnancy criteria

Local Hospital and Health Services provide a limited number of appointments for terminations. Priority appointments for terminations will be given to women with complex health care needs and no ability to have a termination in the private sector where most terminations are performed.

Category 1 - Seen within 30 days

  • Any patient requesting a termination of pregnancy.  For optimum care, an assessment appointment should be offered within 5 days of referral.
    NB: Full termination of pregnancy services may not be offered by individual hospitals. Referral may well be accompanied by a telephone call to the local Hospital and Health Service to establish local guidelines.  This could include discussion with the responsible clinician or delegate. Request for termination service 22+1 weeks have additional complexities and should be discussed with the responsible clinician

Category 2 - Seen within 90 days

  • No category 2 criteria

Category 3 - Seen within 365 days

  • No category 3 criteria

Standard information for all referrals

Reason for request

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for general practitioner or second opinion
  • For a specified test or investigation the general practitioner can't order, or the patient can't afford or access
  • Reassurance for the patient or family
  • For other reason (e.g., rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

Patient's demographic details

  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Phone contact numbers – 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 Torres Strait Islander Ask the patient their ethnicity

Referring practitioner details

  • Full name
  • Full address
  • Contact details – phone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Patient's usual general practitioner (if different from above)

Relevant clinical information about the condition

  • Inclusion of Clinical Prioritisation Criteria (CPC) where relevant
  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Investigations carried out and results as indicated in the relevant pathway
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Options already pursued
  • 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

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 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, WorkCover, motor vehicle insurance)

Essential information

  • Summary of relevant circumstances leading to the request for termination of pregnancy
  • Medical, surgical, obstetric and psychosocial history
  • Menstrual history and last menstrual period (LMP) date (if available)
  • Confirm the diagnosis and gestation of intra-uterine live pregnancy by ultrasound*

*Where access is limited in regional/rural centres consider referral prior to ultrasound

Additional information

  • Blood group and type
  • Routine antenatal bloods: FBC, rubella antibody, hepatitis B serology, hepatitis C serology, HIV serology, syphilis serology
  • HPV vaccination history
  • STI screen result:
    • Endocervical swab or low vaginal SELF SWAB.  Also screen for chlamydia +/- gonorrhoea NAA, T vaginalis, M genitalium (highly desirable)
    • STI screen might not be available before referral but is an essential part of the management.
  • History of smoking and alcohol and drug use
  • If pregnancy > 11 weeks, Down syndrome screening results – screen at 11 to 14 weeks: fetal ultrasound + serum βhCG + serum PAPP-A (results required if completed, not necessary if thinking of Termination of Pregnancy)

Information for your patient

Expected time frame for appointment notifications

  • Once the request is received, categorisation by the hospital will occur.
  • General practitioners and patients are notified of the assigned category between 14 days to 1 month after completed request is received.
  • Patients are usually notified of the upcoming appointment time and date approximately 4 weeks prior unless short notice appointments become available.

Appointment information

  • Patients will be given an appointment via phone, SMS, or letter.
  • The patient must contact the hospital to reschedule if they are not able to attend.
  • If the patient fails to respond to 2 appointment offers:
    • They will be discharged back to their general practitioner.
    • They can have a new request for assessment sent to the hospital if the need still exists.
  • The patient's first appointment may not always be with a specialist. Where appropriate, the request may be sent to a public allied health or nursing service for initial assessment and management. A specialist assessment may then be arranged or ruled out.

Ask your patient to:

  • take a list of current medications, and all relevant radiology films and reports to appointments.
  • advise of any change in circumstance (e.g., getting worse or becoming pregnant), as this may affect the request for assessment.
  • update their contact details (e.g., phone number and address) with the hospital.
Last updated: 24 January 2020

Send referral

Specialist Outpatient Department

Fax: 1300 017 155

CQ Fracture/urgent referrals
Fax: (07) 4920 7242

Named referrals

If you would like to send a named referral, please address it to a specialist listed below.

Rockhampton

  • Dr David Hill, Department Director
  • Dr David Shaker
  • Dr Leigh Grant
  • Dr Lilantha Wedisinghe
  • Dr Theron Moodley
  • Dr Preeti Patil

Gladstone

  • Dr Surafel Alemu, Department Director
  • Dr Clive Green
  • Dr Amita Roy
  • Dr Anja Szabo

Emerald

  • Dr David Hill, Department Director
  • Dr Leigh Grant

Biloela

  • Dr David Hill, Department Director
  • Dr Leigh Grant

> view all CQ Health specialists

Service advice

Rockhampton
Phone: (07) 4920 6440

Gladstone
Phone: (07) 4976 3169

Emerald
Phone: (07) 4987 9750

Biloela
Phone: (07) 4992 7000

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