Specialty: ENT
Age group: Children
Direct to an emergency department for
- Acute tonsillitis with
- difficulty in breathing
- unable to tolerate oral intake
- uncontrolled fever
- Abscess or haematoma (e.g. peritonsillar abscess or quinsy)
- Post-operative tonsillar haemorrhage.
Criteria for referral to public hospital service
- Chronic or recurrent infection with fever or malaise and decreased oral intake and any of the following:
- absent from school or work for four or more weeks in a year
- at least 7 episodes in the past year
- at least 5 episodes each year in the last 2 years
- at least 3 episodes each year in the last 3 years
- Suspicious unilateral tonsillar solid mass with or without ear pain.
Information to be included in the referral
Information that must be provided
- Reason for referral and expectation or outcome, anticipated by the patient, or their carer, and the referring clinician from referral to the health service
- Physical examination
- Details of onset, duration and frequency of infections
- Any history of febrile convulsions or hospital admissions for tonsillitis
- The functional or psychological impact on quality of life or activities of daily living including impact on school, study, or social activities
- Details of previous management including the course of treatment(s) and outcome of treatment(s).
Provide if available
- Statement about the patient’s interest in having surgical treatment if that is a possible intervention
- If the child identifies as an Aboriginal and/or Torres Strait Islander
- If the child is neurodiverse, gender diverse or has a disability
- If the child lives in out-of-home care (foster care, kinship care, permanent care or residential care)
- If the child from a culturally or linguistically diverse background
- If the child is aged 14-18 years, do they consent that their health information is shared with their parent, guardian or carer.
Additional comments
The Minimum information for referrals to non-admitted specialist services lists the information that should be included in a referral request.
Note: there are also statewide referral criteria for Sleep disordered breathing.
The referral should note if the request is for a second or subsequent opinion as requests for a second opinion will usually not be accepted.
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
Referral to a public hospital is not appropriate for
- If the patient is not willing to have surgical treatment.
Reviewed 25 June 2025