Shoulder team Recently there has been an increased number of patients with frozen shoulder referred to the shoulder clinic. Although these patients will be seen, it may aid their management for intervention to occur earlier. The triage team has identified the following symptoms and risk factors which could increase the likelihood of frozen shoulder as a differential diagnosis: • Age 40-60 • Metabolic risk factors (obesity, diabetes, and/or thyroid conditions) • Presence of severe pain +/-night disturbance • Presence of stiffness or reduced movement • Imaging findings associated with frozen shoulder (e.g. long head of biceps effusion, capsular hyperaemia, rotator interval thickening, etc) While patients are on the waiting list, we thank you for continuing to monitor your patient for signs of frozen shoulder, including: • Progressive loss of both active and passive glenohumeral joint external rotation ROM by at least 50% compared to the contralateral side. • No other significant pathology to explain the above stiffness on shoulder XR. If you believe your patient is developing a frozen shoulder, please arrange in primary care: 1. An intra-articular corticosteroid injection (NOT a bursal injection) as early as possible while pain remains a significant issue. 2. Referral to a local physiotherapist or physiotherapy service . Please note we discourage stretching exercises in the early, painful phase of this condition. In this phase, please encourage patients to use the arm within a comfortable range of motion, modify activities accordingly, and use simple analgesia and heat packs. As pain improves, structured stretching exercises can help to regain range of motion. Reference: Rupani N, Gwilym SE; BESS Frozen Shoulder Working Group. British Elbow and Shoulder Society patient care pathway: Frozen shoulder. Shoulder Elbow. 2025 Apr 23:17585732251335955. doi: 10.1177/17585732251335955. Epub ahead of print. PMID: 40291049;
Hospital In the Home HITH is a safe alternative to hospitalisation that is intensive, short-term & multidisciplinary. Clinical conditions include: • Cellulitis Community Acquired Pneumonia • COPD / Bronchiectasis • Urinary Tract Infections • Pyelonephritis Bridging anticoagulation e.g. DVT Subcutaneous fluid rehydration (RACF) • Hyperemesis gravidarum • Exacerbation of chronic Heart Failure • Other conditions appropriate for hospital substitution. Our HITH and Virtual Care Service will continue to provide acute hospital level care in the home for appropriate patients, including: • IV antibiotic therapy and antimicrobial stewardship • Management of chronic complex conditions requiring acute intervention • Complex wound management with IV therapy Referrals to HITH can be made via an a-referral (Health link) or by calling the centralised intake line at 1300 790 790. Available 8am-10pm We wish to advise that from 31st October 2025, the NSLHD Hospital in the Home (HITH) service will no longer be able to provide intravenous iron infusion therapy. The decision was made following a review of our clinical service priorities to ensure we continue to deliver safe, sustainable care for patients in the home. What this means for your patients: • HITH will not be accepting new referrals for iron infusions after October 31st, 2025. • Patients currently receiving iron infusions via HITH will be supported to transition to alternative service providers before the cessation date. We encourage you to refer patients requiring iron infusions to general practices, outpatient clinics, community infusion centres, or mobile infusion services (further information available on the PHN website (General Practices offering Iron Infusion Service). We acknowledge that this change may require adjustments in referral patterns and appreciate your support in ensuring a smooth transition for patients. Our team will collaborate with you to minimise disruption to care. For further information or to discuss patient transition arrangements, please contact Shelley Somi, HITH Nurse Manager-9462 9460/ Shelley.Somi@health.nsw.gov.au
6
GPLink | October 2025
Made with FlippingBook - professional solution for displaying marketing and sales documents online