CPAC020
CLINICAL PRIORITY ACCESS CRITERIA
Service Category: PLASTIC AND
RECONSTRUCTIVE SURGERY
Category Definitions:
1.
2.
3.
4.
Category
1.
Immediate
Treatment
immediately or
within 24 hours
Immediate
Urgent
Semi-urgent
Routine
–
_
–
–
Treatment immediately or within 24 hours
Seen within 3 weeks
Seen within 6 weeks
Seen within 2 months
Criteria

Significant or uncontrolled
bleeding.

Trauma not able to be treated
conservatively.

Acute and significant functional
impairment.

2.
Urgent
Seen within 3
weeks
Patient Type: Outpatient (Assessment)
Examples
(not an exhaustive list)
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Conditions that will cause
permanent tissue or system
damage.

Infection.

Requiring plastic surgical opinion,
assessment and treatment or
condition likely to deteriorate or
cause impairment if left for
extended period without treatment.
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Last updated February 2006
Severe lacerations involving blood
vessels
Severe full thickness burns
Oral trauma causing airway
distress
Severe lacerations involving
nerves, tendons etc
Severed limb/digits
Gustilo scoring system 3b-3c
Major tissue loss requiring
immediate free flap or skin grafts
Complex limb trauma
Necrotising fasciitis
Sternotomy wound dehiscence
Malignant melanoma – proven
biopsy – all levels
Malignant melanoma, not proven
but suspected
Facial skin cancer with neck nodes,
fracture dislocation, i.e. nerve or
tendon damage.
Acute functional impairment
Rapidly growing SCC and BCCs,
especially on the face
Burns presenting non acutely,
requiring plastic assessment
Soft tissue loss not presenting
acutely
Clefts for review if not seen at birth
Recurrent melanoma for limb
perfusion consideration
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CPAC001
3.
Semi-Urgent
Seen within 6
weeks

Condition requiring plastic surgical
assessment as soon as possible,
but condition will not deteriorate if
not seen at short notice. GP can
expedite if condition worsens.

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4.
Routine
Seen within 2
months

Patient at no physical or systemic
risk if not seen by service in any
designated time.
Skin lesions which are growing,
itching, bleeding or suspected to be
skin cancer – not melanoma
Severe Dupuytrens contracture
Conditions causing infections, eg
supprativa hydradenitis, cysts etc
Ulcer clinic
Congenital abnormalities not
reviewed at birth, eg syndactyly
haemangiomata, hypospadias etc
Scar contractures restricting
function
Newborns with birthmarks causing
parental distress

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Skin lesions not malignant
All naevi not causing concern
All cysts not causing concern
Birthmarks
All lipomas
Prominent ears, microtia
Redundant tissue, eg abdomen,
breasts, eyelids, circumcision

Scars for correction not causing
functional impairment

Cosmetic procedures, eg
augmentation mammoplasty
 Delayed breast reconstructions
NOTE: For all in/day/out/community patient referrals:

Emergencies – please refer to admission type Category 1.
Last updated February 2006
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