ENT referral criteria – Adult

Immediate ENT referrals

Immediate referrals (seen within 7 days) are not handled by the Central Referral Service (CRS).

Do not send immediate referrals via CRS – send referrals for patients requiring immediate review (within the next 7 days) directly to the relevant hospital.

Immediately contact the on-call registrar or service to arrange an immediate ENT assessment for:

  • Confirmed head and neck malignancy
  • Sudden hearing loss less than 72 hours with the following associated conditions:
    • trauma
    • foreign body
    • dizziness or vertigo
    • facial numbness or weakness
    • ear pain
    • ear discharge 

To contact the relevant service, please see HealthPathways: Acute ENT Assessment

Excluded ENT services

Excluded Elective Procedures


The WA Elective Surgery Access and Waiting List Management Policy states that all elective procedures performed in the WA health system must meet an identified clinical need to improve the health of the patient. Procedures are not to be performed for cosmetic or other non-medical reasons.


Excluded procedure Exceptional circumstance includes
Surgery for aesthetic reasons  
Correction for aesthetic reasons  
  • except in cases of major facial trauma, congenital abnormality in children causing ongoing clinical issues or where Rhinoplasty is deemed necessary for functional improvement

Excluded procedures will not be performed unless under exceptional circumstances and where a clear clinical need has been identified. For all excluded procedure referrals, state clearly in the referral that request is for an excluded procedure and include the clinical exception reason as to why it should be considered.

The WA Elective Surgery Access and Waiting List Management Policy may be accessed via the WA Health Policy Frameworks page.

Referral to public adult ENT outpatient services is not routinely accepted for the following conditions

Condition Details (where applicable)
Chronic cough
Deviated septum

Excluded condition for the following:

  • In absence of documented nasal obstruction or sinus symptoms
Facial palsy
  • Refer to Neurology
Hearing aid dispensing
Hearing loss

Excluded condition for the following:

Migraine and related conditions
  • Refer to Neurology
Mild acute rhinosinusitis

Excluded condition for the following:

  • Patients with headaches who have normal CT scan which has been performed when the patient has symptoms
  • Patients who have not had three months of intranasal steroid and nasal lavage treatment
  • See HealthPathways: Rhinosinusitis
Recurrent tonsillitis

Excluded condition for the following:

Simple ear drum perforation as a part of acute otitis media

Excluded condition unless the following features apply:

  • If perforation does not resolve or if cholesteatoma is suspected patient needs to be referred
Thyroid mass
  • Non-bacterial thyroiditis
  • Uniform enlarged gland suggestive of thyroiditis without other symptoms
Undifferentiated dizziness
  •  If the referral is sent with no description of the dizziness, then the referral will be rejected
Waxy ears

Excluded condition unless the following features apply:

  • Patients should be referred to ENT if resistant ear wax, after recommended treatment, and at least one of the following symptoms is present:
    • Significant hearing loss
    • Pain
    • Discharge
    • Dizziness/vertigo
    • Facial weakness
Last reviewed: 02-10-2023