Glossary of terms

Access Criteria for First Specialist Assessment (ACA) are guidelines that assist clinicians to prioritise the referrals they receive and help to ensure that the most urgent referrals are seen first.

Active Review is a care pathway for patients for whom elective surgery is considered to be the best option for their care, but where:

• this service is not available within the current public funding or provider capacity; and
• there is a realistic probability that the patient's condition may meet the threshold for treatment in the foreseeable future.

These are the patients who would next receive treatment if provider capacity increases.

While in the category of active review, patients should receive a clinical assessment every six months. If at any time a patient's condition deteriorates to the point where their priority score exceeds the aTT, they should be given a commitment to treatment.

If a patient’s condition remains unchanged by the time of the third assessment, they should be returned to the care of their GP.

Actual Treatment Threshold (aTT) gives an indication of the level at which patients can be given a commitment to treatment (within six months). If resources and patient mix remain the same, a service will be able to treat in the future the same volume of patients it has in the past. Thus, based on this historic treatment pattern, a service can predict to a reasonable degree of accuracy, the volume of patients to whom a commitment to treatment within six months can be given.

Commitment should be given to patients with the highest priority. Patient priority is determined by their level of clinical need and is identified by way of a numerical score. Each service is aware of the lowest priority score at which it has historically been able to treat the majority of its patients.

However, for a variety of reasons, a service will appropriately decide to treat a few additional patients who have relatively low priority scores. In recognition of the existence of this latter group, the actual treatment threshold (aTT) is calculated as the 10th centile priority score assigned to all patients treated in the past 12 months. A service should therefore be able to treat all patients above the aTT.

Booked means that the patient has a firm treatment date within the next six months.

Certainty means that the patient is told that they will receive treatment within the next six months and that the treatment date will be provided closer to the time.

Clinical Priority Assessment Criteria (CPAC) are examples of tools that are available to assist clinicians to assign a priority to patients.

A First Specialist Assessment is the assessment undertaken by a hospital specialist following referral by a patient’s primary care practitioner, usually a general practitioner (GP).

Follow-ups are further assessments by hospital specialists.

General Practitioner (GP) Care means that the patient’s condition has been assessed as currently being of low priority relative to others referred to the same service. The patient is thus returned to the care of their GP and can be re-referred for secondary assistance if their condition changes.

Planned Procedures occur where the timing of the intervention is greater than six months for clinical reasons.

A Plan of Care informs the patients and their primary care practitioner of the probable diagnosis, care plan, the next action planned, and who to contact if there is a problem.

Primary Care services are non-hospital-based service providers such as general practitioners, primary-care-based nurses, and community providers.

Primary Care Management Guidelines are designed to assist primary care practitioners to manage specific clinical conditions in primary care.

Referral Guidelines assist primary care practitioners when referring patients to hospital services for assessment or treatment by outlining the information that should accompany the referral, such as the results of diagnostic tests.

Residual Waiting List patients have no clarity of treatment status.

Secondary Care services are hospital services.

Staged Procedures occur where the intervention is performed in a series of operations. The patient retains the same priority for treatment given in their initial assessment.