Skip links and keyboard navigation

All conditions requiring the Complex Obesity Service

Useful management information

  • Measure waist circumference in addition to calculating BMI  if BMI <40
  • Lifestyle modification (increased activity, dietary, weight, smoking, alcohol)
  • Convey the message that even small amounts of weight loss may improve health and wellbeing
  • Use multicomponent approaches — these work better than single interventions
  • Refer appropriately to assist people to make lifestyle changes or for further intervention
  • Support a self-management approach and provide ongoing monitoring
  • Manage comorbidities when they are identified; do not wait until the person has lost weight
  • Offer people who are not yet ready to change the chance to return for further consultations when they are ready to discuss their weight again and willing or able to make lifestyle changes
  • Assess the person’s readiness to adopt changes and person’s confidence in making changes
  • Alternative services
    • Primary Healthcare services i.e. lifestyle groups
    • GPMP with a TCA and allied health referral
    • COACH for chronic conditions e.g. pre diabetes, T2DM, Heart disease, COPD
    • Get healthy program
    • Bariatric surgery via private system, information to assist finding a surgeon for referral is at Weight Loss Surgery

Minimum referral criteria Does your patient meet the minimum criteria?

Does your patient meet the minimum referral criteria?

Category 1
(appointment within 30 calendar days)

If you feel your patient meets Category 1 criteria, please mark "urgent" on your referral

  • Patients with a serious obesity-related comorbidity^ that is likely to deteriorate quickly, if urgent weight loss is not achieved
  • Patients requiring urgent lifesaving operation/procedure that requires immediate weight loss for surgery/procedure to proceed (e.g. organ transplantation or assessment for organ transplantation, angiogram or cardiac surgery)
    • ^Serious obesity related comorbidities include (not an exhaustive list):
      • severe liver disease with potential treatment
      • severe pulmonary hypertension
      • recurrent venous thromboembolism
      • benign intracranial hypertension
Category 2
(appointment within 90 calendar days)
  • Patients with severe obesity-related comorbidities such as (not an exhaustive list):
    • nephrotic range proteinuria or rapidly progressing renal impairment
    • chronic respiratory failure or obesity hypoventilation syndrome
    • severe OSA
    • recurrent cellulitis or venous ulcerations
    • recurrent hospital admission for an obesity related condition
    • patients requiring weight loss for a semi-urgent or elective operation/procedure
    • poorly controlled diabetes with HbA1c > 9% with BMI > 50
  • Patients with Prader Willi Syndrome  (PWS) unless meet the criteria for Cat 1
Category 3
(appointment within 365 calendar days)
  • No category 3 criteria

If your patient does not meet the minimum referral criteria

  • Consider other treatment pathways or an alternative diagnosis
  • If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
    • Please note that your referral may not be accepted or may be redirected to another service

Standard referral information To be included in 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 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

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
  • A comprehensive capture of information in relation to MSH Referral Criteria

Clinical modifiers

  • The presence of clinical modifiers may impact the categorisation of the patient.
  • 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

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

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.)

 

Essential referral information for All conditions requiring the Complex Obesity Service referrals

  • Height, weight, BMI
  • Summary of weight loss initiatives taken by patient and health care provider prior to referral
  • Details of any allied health support in place to assist with weight loss (any GPMP/TCA in place)
  • Ensure all comorbidities clearly stated
  • Current medication list
  • Details of all treatments offered and efficacy
  • Fasting lipids results
  • FBC, HbA1c, Urinary albumin ratio
  • TSH, ELFTs results

If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the body of the referral.

Additional referral information for All conditions requiring the Complex Obesity Service referrals

  • Advise any risk factors assessed using lipid profile (preferable fasting), BP and HbA1c measurement
  • The person’s lifestyle (diet and physical activity) and eating behaviour and/or any underlying causes for being overweight or obese

Out of catchment

Metro South Health is responsible for providing public health services to the people who reside within its boundaries.  Due to high demand it is not possible to accept referrals from outside this catchment area.  Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service.  If your patient lives outside the Metro South Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

Last updated 1 November 2018