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Paediatric Burns Referral Proforma Guidelines and download form

CHI at Crumlin provides over 80% of paediatric tertiary services in the country.

CHI takes outpatient appointment referrals for patients from primary care (GPs) within the Dublin South County, Kildare and Wicklow area. Referrals will be accepted nationally from Paediatricians. Children will be accepted up to the eve of their 16th Birthday, this will depend on the length of waiting lists within the specialty.

Download CHI Outpatient GP Referral Form

• The outpatient referral form must have all data fields populated in a legible manner.

• All referral forms should be addressed to the Outpatients Appointments Department. This is to assist in the equitable management of referrals, their clinical triage and their allocation of an appointment or entry onto a generic waiting list.

• Urgent referrals can be faxed to OPD Department on 01 409 6801

What you can expect when the referral letter is received:

• If the form is illegible, the referral source will be contacted and the letter may not be progressed to the next stage.

• If the letter is legible, it is date stamped, age profile reviewed, if over the age of reaching 16 years of age the letter will be stamped over age.

• If the referral is not from the appropriate referral source it will be stamped out of catchment area.

• If the letter has ‘Dear Doctor’ the letter will be filtered to the consultant who will be able to clinically triage the letter and assess appropriately.

• Letters will be prioritised by the consultants as follows:

1. Urgent

2. Soon             

3. Routine          

• If a referral is triaged as urgent an appointment date will be issued. 

• If referral is triaged as soon or routine it will depend on the specialty whether an appointment can be issued.

• Families can expect to receive a letter with either an appointment date or an acknowledgement that the letter has been clinically triaged and the child has been placed on the OPD waiting list.  (GPs will receive a copy of this letter).

• CHI at Crumlin will aim to make OPD waiting lists available to referring consultants.

• CHI at Crumlin do not schedule outpatients appointments further than one year in advance.

• The OPD waiting list is a common waiting list and patients will be mobilized from this list in chronological order. It is important to refer to a specialty rather than an individual consultant to assist with managing waiting lists.  Referrals will be directed to the appropriate consultant.

• To assist with this process and workload please refer your patient to one hospital only. Should a referral be sent to the hospital and the patient no longer requires to be seen, please contact us to remove the patient from the waiting list.

• CHI’s OPD operate a consultant lead service with the support of junior hospital doctors.

• CHI operates a strict Did Not Attend Patient Operating Procedure which relates to both new and return appointments.

Contact the OPD Manager directly should you wish to find out more information about a waiting list.

Contact details:

• Telephone 01 4096130

• Fax 01 4096801

• Email Out Patients Department