Royal Perth Hospital Update

Telehealth commitment continues at Royal Perth and Bentley Hospitals

Royal Perth Bentley Group (RPBG) is continuing to encourage the use of telehealth to all outpatients (where clinically appropriate to stay COVID-safe) and minimise the risk to the community, should there be a second wave community transmission in WA. This is also in response to positive patient feedback.

During the initial COVID-19 WA response, Telehealth consultations allowed RPBG to continue to deliver outpatient services while helping to reduce the risk to patients and healthcare workers.

Following feedback that patients enjoy telehealth and the associated benefits, the service has committed to offering telehealth appointments to outpatients where clinically appropriate. Some of these benefits include saving time from not having to wait in clinics, as well as reducing travel commitments – particularly important for regional and remote patients. While both video and telephone telehealth consultations are available, patients are encouraged to opt for video-consultations where possible.

Activity across all telehealth specialties at RPBG is steadily increasing. As patients are choosing to attend their appointments by telehealth more often, RPBG staff are continuing to develop their Digital Health services in collaboration with GPs and other community providers.

For more information about RPBG Telehealth Outpatient Services, please contact 9224 2417 or RPH.Telehealth@health.wa.gov.au

Dr Jacquie Garton-Smith,
Hospital
Liaison GP, Royal Perth Hospital
Email:Jacquie.Garton-Smith@health.wa.gov.au
Mondays and Thursdays

September 2020
Royal Perth Hospital/Diabetes WA Collaboration

Royal Perth Hospital (RPH) is collaborating with Diabetes WA (DWA) to offer patients services from Diabetes WA whilst they await their RPH Diabetes Clinic appointment.

Patients and GPs will be advised by RPH if DWA has been asked to make contact. DWA will contact patients to provide information about diabetes self-management, groups and resources relevant to them. Patients who decide not to accept the support will not have their place on the waitlist for a RPH appointment affected. In addition, for patients who live in regional areas of WA, the possibility of Endocrinologist review via the DWA Telehealth service or a visiting specialist, and/or Credentialed Diabetes Educator Telehealth appointment(s) will also be explored.

Dr Seng Khee Gan, Endocrinology and Diabetes Head of Department said, “This new program aims to enrich the patient journey from the time of referral; and maximise value and input from tertiary services and Diabetes WA in a complementary fashion, with a focus on the patient and their clinical needs.”

Patients can be referred directly to Diabetes WA for diabetes education or for MyDESMOND – online diabetes education. More information on diabetes services can be found on HealthPathways WA Diabetes Requests. If needed, please Request a login or email healthpathways@wapha.org.au

Dr Jacquie Garton-Smith, Hospital
Liaison GP, Royal Perth Hospital
Email:Jacquie.Garton-Smith@health.wa.gov.au
Mondays and Thursdays

Royal Perth Hospital outpatient letter faxing

From Monday 21 September 2020, letters from some RPH outpatient clinics will be automatically faxed to GPs. This will allow GPs to receive outpatient correspondence more quickly and is an interim measure while we work towards secure messaging of outpatient letters.

Where a fax appears to have been successfully transmitted, a hard copy of that outpatient letter will NOT be mailed. Letters from clinics that do not have this facility will continue to be mailed for now, as will letters from Bentley Health Service (unless manually faxed if urgent). Where we do not have your fax number or the fax is not able to be transmitted, the letter will be mailed by post.

Please be sure RPH has your correct fax number. If you currently receive faxed GP notifications or discharge summaries from Royal Perth Hospital, we have your correct fax number. If your contact details or list of doctors working at your practice require checking or alteration, please telephone 9224 3673, fax: 9224 2348 or email on RPH.GPN.Coordinator@health.wa.gov.au

Dr Jacquie Garton-Smith, Hospital
Liaison GP, Royal Perth Hospital
Email:Jacquie.Garton-Smith@health.wa.gov.au
Mondays and Thursdays

Royal Perth Bentley Group – Discharge of Outpatients not booked or planned for further review

A routine audit has identified patients previously been seen in Royal Perth or Bentley outpatients who do not have any further appointments booked or planned with that speciality but have not formally had their outpatient care discharged from our database.

Letters will be sent to the recorded GP of any patient who will be discharged under this audit.

Patients will receive a letter if their last outpatient appointment with that speciality was in the past two years.

 If your patient requires further outpatient care that was not envisaged at the time of last outpatient review, please re-assess the patient and send an updated referral to the Central Referral Service.

Dr Jacquie Garton-Smith, Hospital
Liaison GP, Royal Perth Hospital
Email:Jacquie.Garton-Smith@health.wa.gov.au
Mondays and Thursdays


July 2020
RPH Pain Clinic – Did you know?

Due to significant demand, the waiting list for Royal Perth Pain Clinic appointments is extremely long. Please advise your patients of this prior to referral and offer them other options if possible, especially referral into community-based pain programs. The Pain Management HealthPathways are a valuable resource, especially the information on Interdisciplinary Persistent Pain Programs.

After an initial one day ‘pain education program’ appointment, patients can select appointments with members of the RPH multidisciplinary pain management team. Following assessment a letter including a pain management plan is sent to the patient’s GP to action.

Please advise every patient you refer to RPH for pain management that cannabis products are not prescribed by the RPH Multidisciplinary Pain Management Centre as there is not enough evidence to support cannabis prescribing for persistent pain (http://fpm.anzca.edu.au/documents/pm10-2018.pdf and NICE guidelines ).

Often patients are attending expecting a cannabis prescription which is not clear from the referral. It is very frustrating for patients to wait long periods for a Pain Clinic appointment only to attend and find this will not be recommended or prescribed by our service.

Similarly, evidence shows that for most patients with chronic non-cancer pain, opioids do not provide clinically important improvement in pain or function compared with placebo and in order to reduce opioid-related harm, the service does not generally recommend opioids for chronic non-cancer pain. The ANZCA Faculty of Pain Medicine (FPM) recently reviewed their Statement regarding the use of opioid analgesics in patients with chronic non-cancer pain.

Consumer and health professional resources on opioids are available on the TGA prescription opioids and NPS MedicineWise or Chronic Non-Cancer Pain HealthPathway.

Dr Jacquie Garton-Smith
Hospital Liaison GP, Royal Perth Hospital

Email: Jacquie.Garton-Smith@health.wa.gov.au
Mondays and Thursdays

June 2020
RPH Cardiometabolic Clinic –patients on Evolocumab

In the future, GPs will be asked to take over management of patients with hypercholesterolaemia who have remained stable with minimal side effects after more than 6 months to one year of Evolocumab (Repatha) injections.

Evolocumab is a well-tolerated, injectable monoclonal antibody against proprotein convertase subtilisin/kexin type 9 (PCSK9) with streamlined PBS authority listings that GPs can utilise for patients who:

  • Have heterozygous or homozygous familial hypercholesterolaemia (FH) or non-familial hypercholesterolaemia; and
  • Fail to achieve guideline recommended cholesterol targets on maximally tolerated doses of statins and ezetimibe (including those who are statin intolerant); and
  • Have previously received PBS-subsidised treatment with this drug for these conditions.

Evolocumab is well tolerated, the most common minimal reported side effects are:

  • Local injection site reactions
  • Nasal congestion
  • Back ache

Handover to GPs seeing patients on Evolocumab will occur by letter including target lipids. Patients will also be asked to see their GP for repeat prescriptions of Evolocumab, and to monitor therapeutic efficacy and side effects. The Cardiometabolic Clinic will provide additional support as required. For further information and support, please contact the Cardiometabolic Clinic on 9224 8092.

GPs may be interested in the “Hyperlipidaemia” and “Familial Hypercholesterolaemia” HealthPathways.

Dr Jacquie Garton-Smith
Hospital Liaison GP, Royal Perth Hospital
jacquie.garton-smith@health.wa.gov.au
Available: Monday and Thursday

March 2020
Royal Perth Hospital GP Notify Fax also available by email

Is your practice receiving GP Notify by fax but would prefer email?

GP Notify is an automated notification system that informs the patient’s nominated GP (where registered) of patient admission, discharge and death at Royal Perth Hospital by email or fax.

A technical issue led to all new GP Notify registrations over an extended period being defaulted to fax instead of email. If you would like GP notifications to be sent to your practice by email, please advise the RPH GP Notify Coordinator that you wish to change, including your name, practice and practice email by phoning 9224 2810, faxing 9224 2860 or emailing RPH.GPN.coordinator@health.wa.gov.au

The Patient Administration System used by WA Health, only allows one email address per practice to be registered for GP Notify. For this reason, an email address for your practice is preferred over individual email addresses.

Please note GP Notify is old technology that cannot be sent by secure messaging. Electronic transmission of discharge summaries is by secure messaging and is preferred to fax or mail alone. If you would like to enrol for secure messaging for inpatient discharge summaries, please refer to the Discharge Summaries section at http://www.rph.wa.gov.au/For-health-professionals/GPs/Communication

RPH apologises for any inconvenience.

Dr Jacquie Garton-Smith
Hospital Liaison GP, Royal Perth Hospital
jacquie.garton-smith@health.wa.gov.au
Available: Monday and Thursday

February 2020
Royal Perth Bentley Group increases scope of day surgery

The types of surgery that can safely be performed as day surgery are expanding with some centres aiming for over 70% of all surgery to be undertaken as a day case. Royal Perth Bentley Group (RPBG) is increasing the scope of procedures where the patient can be discharged on the day of surgery to include laparoscopic cholecystectomy, hernia repair and an increasing number of breast surgeries.

With good patient selection and post-operative support, the impact on primary care should be minimal.Patients are screened preoperatively for medical, surgical and social factors that may exclude day surgery.Immediately post discharge, patients can call the ward directly with any concerns about their care.

RPBGvalues GP feedback. Please contact Dr Alison Corbett, Clinical Lead at Alison.Corbett@health.wa.gov.au

Dr Jacquie Garton-Smith
Hospital Liaison GP, Royal Perth Hospital
jacquie.garton-smith@health.wa.gov.au
Available: Monday and Thursday

March 2019
Royal Perth Hospital Outpatient Updates – EMHS Catchment Map and “Excluded Procedure” Referral Changes

Royal Perth Hospital (RPH) will shortly be undertaking an audit of existing referrals for selected conditions to clinics with long waiting times, including referrals for excluded procedures (see below). If you receive a letter notifying you that a previously sent referral does not meet the new criteria, the letter will outline how to proceed.

EMHS Metropolitan catchment map

Do you know the East Metropolitan Health Service catchment area so you can contact the correct hospital to urgently refer patients? The East Metropolitan Health Service metropolitan catchment map and postcodes is now available on the RPH website.

The country areas that generally flow to the EMHS are the Kimberley, Pilbara and Wheatbelt.

For patients residing in the EMHS catchment who require urgent referral to RPH Outpatients, please call the RPH switchboard on 9224 2244 and ask to speak to the registrar or consultant of the specialty team required. Unless advised otherwise, please send urgent referrals accepted after discussion to RPH.OutpatientReferrals@health.wa.gov.au or fax 6477 5199 noting who you spoke to and any instructions that you are given or appointments made on your referral.

More information about Outpatient Referrals to RPH can be found on the RPH website under  For Health Professionals/GPs/Outpatients.

Excluded procedures Royal Perth Hospital outpatient referral criteria introduced

While the WA Health Excluded Procedures precludes procedures performed for cosmetic or other non?medical reasons, procedures which meet an identified clinical need to improve the health of the patient may be undertaken in public hospitals.

To avoid patients unnecessarily waiting for and attending appointments in cases where surgery cannot be offered at RPH, referral criteria have been established for abdominal lipectomy, breast reduction, blepharoplasty, male circumcision, rhinoplasty and varicose veins.

For criteria and further information, please see the relevant speciality page.

Referrals for these procedures still waiting for a first appointment to be allocated will also be reassessed. If you receive a letter notifying you that a previously-sent referral does not meet the new criteria, the letter will outline how to proceed.

Dr Jacquie Garton-Smith

Hospital Liaison GP, Royal Perth Hospital

jacquie.garton-smith@health.wa.gov.au

Available: Monday and Thursday

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