Plastic Surgery

Introduction

Plastics 2015

General Comments and Directions

  • Scoring should be based on the considered view of the clinician taking into account the patient’s history, examination, results of investigations and the clinician’s experience in treating like patients.
  • Criteria only apply for patients where a procedure is indicated and the patient wishes it and all non-surgical therapeutic options have been explored.
  • These criteria only apply to elective and arranged admissions.
  • The score should be calculated during the consultation, and the patient informed whether they will be accepted for publicly funded treatment. This may occur during the first or follow-up consultation, after investigations have assisted with establishing a diagnosis (e.g. CT scans).
  • If due to exceptional factors not included in the prioritisation criteria, the booking status generated does not adequately reflect the patient’s priority, the booking status may be overridden. The reason for the exception must be documented.

More than one procedure

Where two or more related but independent procedures are contemplated at the same operating session the score should relate to the most significant procedure.

Staged Procedures

A treatment procedure may be staged over several months or years. For the purpose of the priority access scoring a related series of treatments should be considered as one event. Repeat scoring is not required.

This tool does not cover:

  • Hand and upper limb conditions – use the Plastics Hand and Upper Limb tool
  • Skin lesions – use the Skin Lesion tool.

Special cases

Automatic Priority

An appropriate priority score reflecting the clinically appropriate timeframe for treatment will be automatically assigned for the following cases.

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Prioritisation

Plastics 2015

Impact on Life
How much does the condition affect the patient?
What is the likelihood of significant deterioration of the condition and its impacts in the next 12 months?
  • (<25%)
  • (25-75%)
  • (>75%)
What would be the consequence of deterioration in the next 12 months?
i.e. increased/additional symptoms, further compromise of function.
  • (change would have no impact on the patient)
  • (change would have little impact on the patient)
  • (change would have significant impact on the patient)
  • (change would have a severe impact on the patient)
What is the degree of improvement on impact on life expected from the operation?
How much will a delay in treatment reduce the ability of this patient to benefit from surgery?
Potential effect on outcome if surgery delayed more than 4 months.