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Planned Care Services

Rheumatology

Referrals and Advice

Below is the latest temporal arteritis / Giant Cell Arteritis fast track pathway in BOP.

For all other information and ongoing management, please see Health Pathways

Suspected Giant Cell Arteritis (GCA) Pathway

Referral Acceptance

Rheumatology referrals are prioritised by Senior Medical Officers based on the information contained within. Additional information should be attached where available. The prioritisation tool used to triage referrals can be found below under Access Criteria.

All accepted referrals will aim to be seen  within a maximum waiting time of 4 months unless there is a clinical reason for delay.

Please note that Arthritis New Zealand no longer has offices in the Bay of Plenty. This means they do not run group sessions anymore. Their toll-free number is 0800 663 463.  

Referral acceptance is a follows:

First Specialist Assessments

Waiting priority 1

Accepted

Waiting priority 2

Accepted

Waiting priority 3

Declined

Waiting priority 4

Declined

Access Criteria

Category Criteria Examples (not an exhaustive list)

1 - Urgent
  • Acute Rheumatological Emergencies with
    threat to life or major
    organs
  • Seropositive immune-mediated inflammatory arthritis
  • Connective tissue disorders including SLE with major organ involvement
  • Systemic Vasculitis with major organ involvement  (unless under local arrangement with other specialities such as immunology and renal medicine)
  • Giant Cell Arteritis/Temporal Arteritis (please follow separate guidelines for referral of this condition)
  • Autoimmune myositis with major organ involvement
  • Seropositive (Rheumatoid factor/ CCP antibody positive) Rheumatoid Arthritis 

2 - Semi-Urgent
  • Potential destructive inflammatory arthritis
    requiring early DMARD treatment or
    corticosteroids
  • Conditions in the example list that do not have a threat to life or major organs
  • Immune-mediated inflammatory arthritis including seronegative rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, juvenile idiopathic arthritis
  • Connective tissue disorders/ vasculitis without suspicion of major organ involvement

3 - Routine
(Not accepted)
  • Suspected inflammatory rheumatological
    problems which have not responded to primary care management
  • Non-inflammatory
    conditions with major
    social impact (e.g. loss of employment)
  • Difficult to manage gout and polymalgia rheumatica
  • Acute soft tissue problems requiring Gout intervention

4 - Non-Urgent
(Not accepted)
  • Suspected inflammatory rheumatology problems managed in primary care
  • Non-inflammatory disease
  • Gout and other crystal arthritis
  • Classical Polymalgia Arthritis
  • Osteoarthritis
  • Mechanical back pain
  • Fibromyalgia
  • Hypermobililty syndromes including Ehlers Danlos Syndrome
  • Non-inflammatory painful musculoskeletel conditions


Note: 

This list is only applicable for adult patients aged 16 and over. Children are usually managed by Paediatricians with referral to a Paediatric Rheumatologist as required.
Septic arthritis should be referred to the emergency department for consideration of intravenous antibiotics and orthopaedic opinion if deemed appropriate.