1. Overview

This SOP outlines the process for managing urgent maternity ultrasound referrals submitted via the POAC website using the Counties Manukau Health (CMH) urgent scan request form. Referrals are generally submitted by a Lead Maternity Carer (LMC)/Midwife or the Middlemore Hospital Obstetric Team.

2. Referral Receipt and Filing

• Referrals will be received in the POAC referrals inbox.

• Move maternity referrals into the ‘Maternity’ subfolder.

• Open the referral email and check the content for completeness.

3. POAC Database Entry

• Enter the referral into the POAC Counties Manukau database.

• Use the UMAT reference number as the case number.

• If the patient’s NHI is not showing in the database, check TestSafe to confirm the correct patient details.

• In the Free Text Notes field, copy and paste the full body of the referral email (go to email, click Ctrl+A to highlight all, Ctrl+C to copy, Ctrl+V to paste).

• Include a brief scan summary such as:
  CMAT62953, Small for gestational age >34 weeks, Doppler/Liquor (copy from the email body)

• Select the following database fields:

  • Diagnosis: CMH maternity

  • Referral initiated by: GP

  • Organisation: Middlemore Hospital

  • Provider: Obstetrics

• Note: Suspected ectopic pregnancy scans are acute POAC scans across all three districts. Use the appropriate gynaecology - ectopic pregnancy code instead.

• The referral PDF does not need to be attached to the POAC database.

4. Funding Check

• If no funding voucher is recorded:

  1. It may mean the referrer did not have access to this.

  2. Or was unsure if funded voucher required.

• Check JotForm to see if there is a valid CMAT number.

• If CMAT number is found, inform the radiology provider.

• If the patient has confirmed self-funding, omit the "no cost" statement in communication with the patient.

5. Booking Radiology Appointment

• Contact the radiology provider via phone, email, or LUX online booking.

• Record the appointment details in the POAC database.

• If delays in booking occur, inform the referrer and continue attempting to schedule the scan.

• If the patient is close to delivery, check TestSafe to see if delivery has already occurred.

• Although ideally within 48 hours, appointments are often scheduled within 1 week due to capacity.

6. Patient Communication

Text the patient using the following template:

Hi [Patient Name],
We have received a request to arrange an urgent ultrasound appointment for you and your baby.
This has been booked at: [PROVIDER NAME, ADDRESS, TIME AND DATE].
There is no cost to you for the scan.
Please confirm your attendance, as soon as possible, by reply text.

Note: If the patient is self-funding, omit the "no cost" line.

7. Inbox Email Status Tracking

• Open the email, double-click the subject line, and add a comment such as:

  • "Pending reply from [name]"

  • "Appt confirmed @ [provider], [date/time]"

• Close and save the email to update the record.

• Once referral is complete, move the email to the ‘Archived’ subfolder.

8. Example Templates for Communicating with the Referrer

Ensure the patient NHI/name is always included in the subject line and any communication to ensure ease of tracking.

Email 1: Acute Admission Avoidance – Unable to Schedule

Thank you for your referral for the above-mentioned patient.

Unfortunately, due to high demand and limited availability, we are unable to arrange the requested radiology in the required timeframe.

As this referral has been marked for acute admission avoidance, we recommend proceeding with hospital admission for in-person assessment and imaging.

We apologise for the delay and any inconvenience this may cause. Please don’t hesitate to contact us if we can assist further.

Email 2: Unable to Contact Patient

We are writing regarding the radiology referral for the above-mentioned patient.

Despite multiple attempts, we have been unsuccessful in contacting the patient to confirm attendance.

We kindly request that you or the Lead Maternity Carer (LMC) make contact with the patient to ensure they are aware of the referral and will attend the appointment.

Email 3: Delayed Booking

We are writing regarding the radiology referral for the above-mentioned patient.

At this stage, we have not yet managed to confirm a suitable appointment time with the patient, but we will continue our efforts to do so.

If the patient requires more urgent assessment, we recommend arranging an in-person review and imaging. Please let us know if you wish to proceed with this and cancel the current request.

Thank you for your understanding, and please don’t hesitate to contact us if we can assist further.