POAC Funded Head CT

POAC funding is available for CT Head to avoid acute hospital referral under the following circumstances:

• Upon endorsement (must have name documented) normally by Neurology, or, for TIA, a Stroke specialist

• For patients who would otherwise be accepted immediately into ED for an assessment, which may be avoided by accessing CT head in the community within a 24-48h timeframe.

• Non-hospital assessment must be a safe option.

 Note that:

• GP may need to discuss further with the specialist if there is uncertainty e.g. lack of clarity around the need for a scan in a POAC timeframe (next 24-48 hours), or if POAC cannot get a scan in the designated timeframe.

• If POAC cannot get a scan within the required timeframe, the referrer will be contacted immediately.

• POAC cannot get same-day scans and cannot get investigations on weekends or public holidays. If a scan can wait until after a weekend or public holiday (ie > 48 hours), it is most likely not a case that falls under the POAC funding criteria.

• POAC does NOT fund injury-related CT heads. POAC has not gained agreement for ACC to fund injury-related CT head outside of the hospital, so ACC patients will have to continue to be assessed in ED

• If CT head is required less acutely (> 48 hours), submit eReferral for urgent CT head, document the name of the endorsing clinician.

CT HEAD NOT FUNDED BY POAC (LIST NOT EXHAUSTIVE):

• Chronic symptoms

• Head injury

• Stroke

• TIA, where the TIA HealthPathway recommends acute assessment (i.e. all TIAs occurring in the last 24 hours, and many TIAs occurring in the last 7 days).  See TIA HealthPathway here

• Cognitive impairment

HOW TO REQUEST:

1. Discuss case with Neurology or Stroke service (as above).  Confirm appropriate for POAC AND the timeframe required (e.g. within 24 hours)

2. Email the radiology request form to referral@poac.co.nz (ensure the name of the endorsing specialist is documented)

3. Phone POAC (09) 535 7218 to confirm booking can be facilitated within the required timeframe (if unable to schedule, acute admission may be required).

4. POAC coordinators will schedule appointment and inform the patient or clinic staff member as per the agreed plan.

   Be aware that the referring community clinician is responsible for:

• safety-netting while the patient waits for the CT Head scan appointment, AND

• following up the CT Head report and taking any appropriate clinical actions.