|Document ID:||Operational Circular OP 1869/04|
|Date of issue:||Thursday, 11 November 2004|
|Status:||NO LONGER APPLICABLE|
|File number(s):||03-04972; 03-04935|
|Description:||This Circular is a guide to public hospitals and health services regarding excluded procedures. It advises public hospitals and health services on which procedures should not be performed without approval and indicates the clinical, cultural and religious exceptions. The Circular also sets out the process for gaining approval to perform an excluded procedure and the appeal mechanism, and indicates the Department's position on Patient Assisted Travel for these procedures.|
|Applicable to:||Clinical and administrative staff of public hospitals and health services|
|Period of effect:||from 1 November 2004|
|Authorised by:||Dr Andrew Robertson, Director, Clinical Policy and Programs, 04-Nov-2004|
|Print version:||View print version|
This Operational Circular outlines the recommendations of the Director General of Health in relation to surgical procedures that will not be undertaken in a Public Hospital in Western Australia. For the purposes of this Operational Circular, this also includes public patients in Joondalup and Peel Health Campuses and private patients in Public Hospitals.
Additions to Elective Surgery Waiting List
As from 18 December 2003 the following list of surgical procedures cannot be performed in public hospitals in Western Australia except for clinically significant indications.
Arrangements for Circumcision
For certain cultural and religious groups, male circumcision is mandatory and will be performed regardless of clinical approval. Risks of circumcision include infection, haemorrhage, traumatic amputation and psychological disturbance (if performed without anaesthetic in a pubertal male). For reasons of patient safety and comfort, circumcision should be performed in a sterile environment with appropriate monitoring facilities and access to anaesthesia for older males. Established cultural or religious practice where circumcision is mandatory are grounds for approval of this excluded procedure.
Neonatal circumcision within 28 days of delivery is permissible under the following conditions:
Elective Surgery Waiting List prior to January 2004
Patients already wait listed for the above surgical procedures were removed from the Elective Surgery Waiting List by January 2004.
It was the responsibility of the Medical Director of each hospital to:
New listings on the Elective Surgery Waiting List
If a medical practitioner believes that an excluded procedure is clinically, culturally or religiously indicated, the following procedure should be followed:
The Minister for Health has endorsed the following amendment to the Patient Assisted Travel Scheme (PATS) eligibility guidelines. As of 1 April 2004, patients travelling for excluded procedures as defined by this Operational Circular are not eligible for PATS assistance. This restriction will apply to patients who are travelling to a private facility for excluded procedures not available through their local public hospital.
Approval for assistance by the relevant Area Director of Medical Services or their medically qualified delegate can be given in exceptional clinical circumstances. Should the decision of the Director of Medical Services be disputed by the medical practitioner, the case should be referred by the Director of Medical Services in writing, including all pertinent details, to the Chief Medical Officer who will review the circumstances.
Auditing and Reporting
Auditing, monitoring, and reporting of these excluded procedures will be undertaken by the Central Wait List Bureau Resource Management (CWLB) to ensure compliance with this Circular. Performance reporting will be provided to the State Health Management Team. Audit will include;
General Practice Divisions and Royal Colleges
This Operational Circular will be provided to General Practice Divisions and Royal Colleges for the information of their members.
Dr Andrew Robertson
This circular last updated: Thursday, 11 November 2004 at 12:00am