ENT referral criteria – Paediatric

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 ENT registrar or service to arrange an immediate ENT assessment for:

  • Acute episode tonsillitis with non-resolution despite optimal medical management
  • Acute nasal trauma with external open bone displacement
  • Clinical concern regarding prolonged apnoeas, cyanosis, altered level of consciousness or significant and escalating parental concerns should prompt direct phone contact with the ENT registrar on call to discuss the case and arrange review as clinically appropriate
  • Conductive hearing loss if acute event with ear discharge
  • Facial cellulitis  
  • Noisy breathing, voice change or severe odynophagia / obstructive sleep apnoea
  • Suspected neoplasm – ulceration, or recurrent unilateral enlargement, particularly with associated cervical lymphadenopathy

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

Excluded paediatric 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 circumstances includes
 Aesthetic surgery  

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 paediatric ENT outpatient services is not routinely accepted for the following conditions:

Condition Details (where applicable)
Discharging ear

Excluded condition when the following features apply:

  • Waxy ear discharge
Hearing aid dispensing
Hearing loss

Excluded condition when the following features apply:

  • Patients with a normal audiogram
Mild acute rhinosinusitis
  • Patients with headaches who have a 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
Recurrent tonsillitis

Excluded condition when the following features apply:

  • If the patient is/parents are not willing to have surgical treatment
  • Halitosis without other symptoms
Simple ear drum perforation as a part of acute otitis media
Last reviewed: 05-01-2024