Managing Elective Surgery patients in act public hospitals contents
Excluded Procedures (Cosmetic and Discretionary)
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- Phimosis, paraphimosis, balanitis, Frenulum breve
- CEAP Grade >2
2.3 Excluded Procedures (Cosmetic and Discretionary)Surgery should meet an identified clinical need to improve the physical health of the patient. The following list of surgical procedures should not be performed in public hospitals in the ACT. For procedures not appearing on the list below that could be interpreted as cosmetic in nature, the RFA should be referred to the Director Territory Wide Surgical Services for review prior to the patient being added to the elective surgery waiting list.
There may be instances where the Medical Officer wishes to apply for an exemption to the exclusion list or other cosmetic procedure. The Medical Officer must include with this application verifiable clinical evidence to support this application. For example, a patient requesting breast reduction or abdominoplasty for severe intertrigo will need a letter from a dermatologist stating this procedure is clinically required to improve this patient’s health after failure of medical therapy, or documented evidence of two admissions to hospital for treatment of cellulites. If a patient requests an excluded procedure for alleviation of significant psychiatric symptoms a letter from a Psychiatrist will need to be included with the outpatient department referral stating this procedure is required to improve the patient’s mental state. Similarly, if a patient is requesting an upper or lower eyelid Blepharoplasty the Medical Officer must document one of the following rationales on the RFA or supply photographic evidence. Vision obscured as evidenced by upper eyelid skin resting on lashes on straight ahead gaze Herniation of orbital fat in exophthalmos Facial nerve palsy or post traumatic scarring Restoration of symmetry of contralateral eyelid in respect of one of the above conditions This application must be forwarded to the Director, Territory Wide Surgical Services (TWSS) (andrew.w.mitchell@act.gov.au) for review and endorsement. If, on the evidence supplied, the Director TWSS endorses the application, the referral/request would then be forwarded to the relevant hospital Surgical Director for final endorsement following assessment at the hospital site to determine the capacity to undertake the procedure. It must be stressed the occasions for acceptance to undertake an excluded procedure would be rare, and patients should be counselled that there is no guarantee that exception to the excluded criteria provisions would be granted. This policy does not include gender reassignment procedures for which there are no exceptions (adults), nor breast reduction for back pain. Download 0.95 Mb. Share with your friends:
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