Endocrine  |  Elective Services


Elective Services

National Access Criteria for First Assessment (ACA)

Endocrine referrals are prioritised by senior medical officers based on the information contained within. Additional information  should be attached where available. The priorisation tool used to grade referrals can be found below.

Bay of Plenty Variation (April 2014)

Note:  Access criteria that determine prioritisation primarily on the referral diagnosis have their limitations and this is acknowledged.  For those referrals in which the referring doctor has not been able to make a confident diagnosis it may be difficult, or impossible, to apply these ACA criteria.  It is therefore stressed that these are guidelines only and that clinical judgement must be applied in all cases in which they are used.

Referral Guidelines:  Endocrinology


Examples (not an exhaustive list)

1.     Immediate

  • Endocrine patients with significant clinical risk

2.     Urgent

  •  Endocrine patients with significant clinical risk

2A.  Semi-Urgent


  • Pituitary tumours- functional and non-functional
  • Significant symptomatic hyperthyroidism
  • Adrenal disorders - eg: Addison's Disease, Pheochromocytoma
  • Severe, symptomatic hypercalcalmia serum Ca²+ ≥ 3.0 mmol/L with raised PTH

2B.   Semi-Urgent


  • Pituitary dysfunction
  • Serum Ca++ between 2.7 - 3.0 mmol/L and ↑ PTH
  • Hirsuitism with raised testosterone > 5 mmol/L
  • Unexplained significant osteoporosis

3.  Routine

  • Hypogonadism, Simple hirsuitism, PCOS, Serum Ca²+ < 2.7 mmol/L, Simple Osteoporosis, Therapy for gender issues, Hypothyroidism

:  Ophthalmic symptoms associated with pituitary tumours or thyrotoxicosis (Graves' disease) may need direct referral to Ophthalmology Service as well. 

Last updated : Tuesday, September 29, 2015
Next review date : Wednesday, September 28,2016

Disclaimer: This site is intended to be flexible and frequently updated. While every effort has been made to ensure accuracy, all information should be verified.