ENT (Adult) Referral Access Criteria

Patient requires immediate (within 7 days) attention
Immediate referrals (patient to be seen within 7 days) should be sent directly to the relevant hospital. Do not send immediate referrals via Central Referral Service (CRS).

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

  • Acute hearing loss
    • 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
  • Chronic hearing loss
    • Chronic hearing loss (more than 72 hours) with the following associated conditions:
      • trauma
      • foreign body
      • dizziness or vertigo
      • facial numbness or weakness
      • ear pain
      • ear discharge
  • Head and neck mass (ENT)
    • Confirmed head and neck malignancy
  • Nasal fracture (acute)
    • Acute nasal fracture requiring surgical intervention i.e. external bone displacement (best results for acute nasal fracture are achieved within 2 weeks from time of injury)
To contact the relevant service, please see HealthPathways: Acute ENT Assessment (external site)
Ear, Nose and Throat (adult) conditions with Referral Access Criteria

These conditions are routinely seen by ENT (adult) outpatient services. This is not an exhaustive list of all conditions seen by the outpatient service. Consideration for referral will not be excluded unless the condition is listed on the exclusion list. If the condition you are referring for is not listed, or is unknown, please include details in the body of the referral.

Referrals missing 'mandatory information' with no explanation provided may not be accepted.

Excluded conditions and services


Referrals to public ENT (adult) outpatient services are 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
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

Excluded Elective Procedures


All elective procedures 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 procedures will not be performed unless under exceptional circumstances and where a clear clinical need has been identified. For excluded procedures, the referral must clearly state:

  • that the request is for an excluded procedure
  • the clinical exception reason as to why it should be considered.

Access the WA Elective Surgery Access and Waiting List Management Policy at WA Health Policy Frameworks.

Excluded procedure Exceptional circumstance includes
Surgery for aesthetic reasons  
Correction for bat ears  
  • except in cases of major facial trauma, congenital abnormality in children causing ongoing clinical issues or where Rhinoplasty is deemed necessary for functional improvement
Last reviewed: 02-10-2023