Gastrointestinal endoscopy (direct access) - Adult

From 27th September 2022 the NEW Direct Access Gastrointestinal Endoscopy Referral Form will apply to all Direct Access Gastrointestinal Endoscopy requests submitted via Central Referral Service for public metropolitan hospitals in WA.
Emergency gastrointestinal endoscopy (direct access) referrals

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek urgent medical advice if in a remote region. 

  • Life threatening symptoms suggestive of
    • Bowel obstruction
    • Abdominal sepsis
    • Acute severe colitis
    • Acute large volume rectal bleeding
  • Significant acute upper GI bleeding (e.g. haematemesis, melaena)
Immediate gastrointestinal endoscopy (direct access) referrals

Immediate referrals:

  • Nil
In scope gastrointestinal endoscopy (direct access) conditions
Excluded gastrointestinal endoscopy (direct access) services

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.

Out of scope / excluded procedures

  • Nil

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 WA Health Policy Frameworks.

Referral to public gastrointestinal endoscopy (direct access) - Adult endoscopy (direct access) outpatient services is not routinely accepted for the following conditions

Condition Details (where applicable)
Anaemia not due to iron deficiency
Positive iFOBT in the context of a recent (within 2 years), complete colonoscopy

If still concerned call on-call Registrar to discuss value of referral for repeat endoscopy procedure.

Patients with diarrhoea ≤6 weeks or those with diarrhoea >6 weeks without evidence of stool specimen
Patients younger than 45 years who have altered bowel habit in absence of alarm symptoms
Unexplained dyspepsia in absence of alarm symptoms
Assessment of extraoesophageal GORD symptoms including choking, coughing, hoarseness, asthma, laryngitis, chronic sore throat, or dental erosions.

More information

Email: DOHSpecialistRAC@health.wa.gov.au