POAC RADIOLOGY SERVICES
Non-acute X-Ray and USS that do not meet POAC funding criteria, should continue to be referred using Access to Diagnostics, Hospital Radiology e-Referral, ACC, or Private Funding. This includes Auckland/Waitemata AUB pathway scans.
Head CT requests for minor injury under ACC should be referred to the Emergency Department and will not be accepted under POAC funding.
Submit Online Referral
This form can be used for radiology requests for hospitals, hospices, and other clinicians unable to access via direct PMS referral.
This form should NOT be used for any obstetric related referrals.
Latest Updates - ACC Head CT Requests (until 30 Sept 23)
ACC HEAD CT REQUESTS - Following minor head injury (Short Term Only)
A short-term winter funding initiative for CT Head scans to be performed in the community following minor head injury is available until the end of September 2023.
Patients with a minor head injury who meet specific referral criteria may be able to have a CT Head in the community, via POAC, as an alternative to sending the patient to ED for assessment. Patients must have been discussed with, and endorsed by, an ED consultant who will also provide a time frame in which the CT needs to be completed.
If POAC is unable to arrange a CT Head in the appropriate time frame for some patients, due to limited CT Head capacity in the community at that time, POAC will contact the referring clinician (GP, UC, NP) immediately and advise them that the CT Head cannot be done. The patient should then be sent directly into ED without further discussion with an ED consultant. An acute admission eReferral will need to be sent.
For further information including the specific referral criteria, see further details HERE.
Referrals should be submitted via your practice PMS in the normal way, call POAC (09) 535 7218 to discuss and book.
Adult Ultrasound and CT
Phone (09) 535 7218 to request CT or Ultrasound appointments which will be facilitated by POAC coordination team.
The following are standard presentations eligible for POAC. Other services may be available, please call to discuss.
DVT Doppler Ultrasound (see DVT pathway)
Upper Abdominal Ultrasound (see Gallstones pathway)
Testicular Ultrasound (urgent/same day and endorsed by Urology Consultant)
CT KUB or Renal Ultrasound (see Renal Colic Pathway)
Soft Tissue Ultrasound
Pelvic Ultrasound (if required acutely within 24-48 hrs and this will change immediate management).
CT Head - non-contrast urgent (non-ACC) MUST have named endorsing Neurologist (UNTIL 30TH SEPT 2023 ONLY)
If emailing requests, kindly ensure the radiology form is attached
POAC funding may be used for patients who are a distance from the hospital grounds (or other barriers to access) and need an urgent, same-day X-ray to assist in immediate clinical management and avoid an acute hospital presentation.
Under these circumstances, POAC will provide funding for the following acute (same-day) X-rays:
MUSCULOSKELETAL X-RAY - ACC SURCHARGES
Applies only to injuries initiated by St John, hospital, OR via an Emergency Q Voucher
Non-ACC only (e.g. ingested FB) - refer FB Ingested by Children HealthPathway here
CXR is usually not required in the initial community management of Community-Acquired Pneumonia. They may however be required if the diagnosis is uncertain and the findings will alter clinical acute management. For further information click here
POAC does not fund CXR for post-viral cough, including COVID-19 infection or suspected TB (except for Ukraine refugees). Use hospital walk-in service, access to diagnostics, or eReferral.
Consider using a hospital walk-in service for plain X-rays.
For POAC funding to apply, same-day follow-up of the X-ray result must be documented in the clinical notes.
Ultrasound Funding Exclusions
Injury-related investigations should be arranged under ACC funding in the first instance.
POAC will assist with the coordination of ACC-related DVT ultrasounds. These remain under ACC funded with POAC covering co-payment only.
All pregnancy-related ultrasounds should be referred under maternity funding. POAC funding is available where >2 weeks post miscarriage/termination or >6 weeks postpartum.
Urgent or routine investigations are not funded under POAC and can be accessed by eReferral to DHB, Access to Diagnostics, or private funding/insurance.
Paediatric Radiology Services (0-15 years)
POAC funded radiology is available for paediatrics (0-15 year olds) where required acutely to avoid same day admission. Consider discussing with paediatrician.
For all Ultrasound and CT appointments see Auckland Regional HealthPathways, discuss with on-call paediatric service and call POAC with name of specialist endorsing the investigation to arrange an appointment.
Starship Children's Hospital: 021 927 680
Kidz First (MMH): 021 516 908 or (09) 250 3820
North Shore and Waitakere: 0800 244 533
Using the practice management system (or paper referral) generate the POAC case number and write a radiology request form. Advise the patient/carer to attend a private radiology provider of their choice with the request form.
For Counties Manukau obstetric vouchers and acute requests, please use the CLICK HERE
Clinical Policies and Resources
Hospital Radiology Contact
Seek radiology advice about the appropriate imaging to help:
manage the patient.
clarify the interpretation of prior imaging.
avoid unnecessary specialist appointments or emergency department referrals.
Auckland 027 491 9589 or (09) 307 2800
Counties Manukau (09) 276‑0044 ext. 53462
Waitemata 021 874 664 or (09) 486 8920 ext 42771
Options if practice has no ATD budget left and investigation is indicated
Explore the patient's ability to pay.
If imaging is indicated as part of discharge planning or follow-up from previous abnormal results from the hospital, select the "imaging requested by hospital provider" checkbox on the ATD ProExtra form and proceed with the request. (This will be taken into account when the practice's budget use is reviewed.)
If the imaging is not urgent, put the patient on in-practice waiting list and issue the imaging request the following month.
If imaging is required more urgently and your practice is:
not "hard floored" or "on notice", proceed with the ATD ProExtra request. Explain why the imaging is required more urgently.
POAC will fund non-injury-related head CT scans where required within 24-48 hours. Neurology Endorsement is required.
Discuss with Neurology SMO, Auckland Hospital.
The name of clinician endorsing must be on the radiology request form.
Mon-Fri 8am-10pm: (09) 307 2800 or (09) 375 3484
After Hours: (09) 307 2800 or (09) 375 3484
Is this injury-related and required acutely?
Refer to Emergency Department (no community-funded CT available)
CT KUB - Renal Colic
POAC fund CT KUB (kidney, urethra, bladder) for Renal Colic:
Red flags - discuss with urology
Temp >38 degrees, peritonitis, creatinine >160/L, known renal disease, risk of kidney failure, solitary kidney
Patient aged 50 years + - straight to CT KUB under POAC
Under 50 years - IM/PR pain relief in the clinic, repeat after 20 mins if required.
If pain does not settle proceed CT KUB under POAC
If pain settles with IM/PR pain relief - check bloods and discharge with analgesia and review as required.
Subsequent presentation/pain does not settle (1-4 days):
Arrange POAC CT KUB (non-contrast), or renal USS if pregnant
POAC funded review within 48 hours or clinically indicated
Non-contrast CT KUB only, unless specifically requested by urology
Rule out pregnancy in women of childbearing age prior to referring for CT scan. If pregnant, refer renal USS.
Other CT Scans
f required within 24-48 hours - discuss with the relevant hospital specialty. POAC funding will require a named endorsement.
Signs and Symptoms of DVT
Superficial Thrombophlebitis, OR
Upper Limb (Arm), OR
Wells 2 or more
Requires named haematology endorsement
Delayed Scan > 6 hours:
Clinician should consider anticoagulation - oral rivaroxaban unless contraindicated.
New symptoms - chest pain, shortness of breath (SOB), Suspected pulmonary embolism (PE). Discuss with haematologist.
Upper Abdo USS (RUQ Pain)
Right Upper Quadrant Pain, suspected Gallstones (4-6 hours fasting required)
IM pain relief in clinic:
Ongoing severe - refer hospital
Partially settled, or settled but markedly abnormal LFTs - POAC-funded Upper Abdo Ultrasound
Pain persistent or recurrent last 1-4 days - POAC-funded Upper Abdo Ultrasound
Fully settled - order bloods and e-Referral or Access to Diagnostics (ATD) referral for non-acute USS
Suspected cholecystitis, cholangitis, pancreatitis, uncontrolled pain with IM analgesia in clinic - discuss on-call surgical team to consider admission.