Complex or undifferentiated medical problems

Cat 1 · 30 days

appointment within 30 calendar days. - Unstable co-morbidities which require early medical intervention to prevent further deterioration that may result in emergency hospitalisation* - Recent discharge from hospital or emergency department (<4 weeks) and need for ongoing surveillance and optimisation of co-morbidities - Acute exacerbation of chronic medical condition which impacts on other co-morbidities and requires close monitoring - Rapidly progressive or recent onset of undifferentiated syndromes (eg pyrexia [T<39°C] of unknown origin, marked decline in cognitive function, generalised sub-acute myalgia/arthralgia or other undifferentiated rheumatic syndromes, generalised lymphadenopathy) for which definitive diagnosis and/or management plan is required - Fatigue lasting more than 3 months and any of the following: - significant weight loss (≥5% body weight in previous 6 months) - recent and/or progressive onset in previously well, older patient - dyspnoea or other features suggestive of cardiorespiratory compromise - unexplained lymphadenopathy - presence of fever * If further deterioration in symptomatology; these unstable patients should present to the nearest Emergency Department without delay; and not wait for their Cat 1 clinic appointments

Cat 2 · 90 days

appointment within 90 calendar days. - Stable co-morbidities that require risk assessment and medical optimisation - Stable or slowly progressive undifferentiated syndromes (eg fatigue, decline in cognitive function, generalised lymphadenopathy) for which definitive diagnosis and/or management plan is required - Chronic symptoms (eg dyspnoea, dizziness, imbalance) or condition requiring investigations and management to minimise long term impairment - Chronic symptoms causing significant social/economic/functional impairment - Diagnostic dilemmas requiring further investigation or confirmation - Connective tissue disease which is active but not life threatening - Polymyalgia rheumatica (PMR) - Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME-CFS): If there is significant uncertainty about the diagnosis

Cat 3 · 365 days

appointment within 365 calendar days. - Multiple co-morbidities in need of regular review where referral to two or more specialty clinics imposes an unacceptable burden on patients - Soft tissue rheumatism - Non-progressive fatigue lasting longer than 3 months that remains unexplained despite detailed investigation - Myalgic Encephalomyelitis/Chronic Fatigue Syndrome