• Superficial skin or subcutaneous lumps (lipoma, sebaceous cyst, papilloma) < 5cm, located over the torso and neck only

1. Lump size > 5 cm
2. Facial lumps
3. Axillary lumps
4. Infection, ulceration or abscess of the skin
5. Breast lumps
6. Thyroid lumps
7. Peri-anal lumps
8. Genital lumps
9. Suspicious features
10. Infected lesions
11. Patients on airborne/ droplet transmission precautions that require isolation nursing care

• Superficial skin or subcutaneous lumps (lipoma, sebaceous cyst, papilloma) < 5cm, located over the upper and lower limbs
• Ganglion cysts of the hand < 3cm

1. Lump size > 5 cm
2. Ganglion > 3cm
3. Suspicious features
4. Infected lesions
5. Patients on airborne/ droplet transmission precautions that require isolation nursing care

• Superficial skin lumps over the head and neck (e.g. sebaceous cysts)
• Lip mucoceles
• Tongue pyogenic granulomas which are 1cm or less

1. Lump size > 1 cm​
2. Infected lesions
3. Patients on airborne/ droplet transmission precautions that require isolation nursing care

• Patient is alert and ambulant and assessed to have impacted ear wax as the only complaint

1. No previous history of ear surgery on the same side
2. Does not have any of the following: otorrhoea, otalgia, vertigo
3. Consider referring to ED or ENT Hot Clinic for concurrent infection

List of procedures available:

• Dentofacial trauma
• Surgical excision of fractured/impacted teeth
• Incision & drainage (I&D) of orofacial abscesses
• Excision of lesions with or without biopsy
• Mucoceles / lumps of the oral cavity

1. Require sedation
2. Require sedation
3. ​​On dual antiplatelets and/or anticoagulants with INR > 2.5

CT KUB

• Adults with suspected renal colic.

CT KUB

• Prior CT study performed within 3 months.
• Not a candidate for ionising radiation study (e.g. pregnant patient).

CT Lung Screen

• Adult patients aged 50 to 80 years old and,
• 20 pack-year smoking history and,
• Currently smoking or quitted smoking for less than 15 years.

CT Lung Screen

• Less than 50 years old or above 80 years old.
• Quitted smoking for more than 15 years.
• Not a candidate for curative treatment for lung cancer.
• Not a candidate for ionising radiation study (e.g. pregnant patient)

• Peripheral arterial disease
• Part of diabetic foot screening

• Presence of foot wounds (at ankle and distally)
• Patients with DFU should be referred expediently to WH LEAPP (Lower Extremity Amputation Prevention Programme) clinics

• Unable to stand for >30 minutes​
• Presence of active cellulites
• Presence of ulcers on shin / calf

• Clinical suspicion of symptomatic pulmonary embolism
• Presence of active cellulites

• Recurrent upper abdominal pain/ bloating
• Recurrent reflux / heartburn

Patient characteristics

• Unable to open mouth wider than 3cm between the upper and lower incisors
• Unable to give consent < 21 years old, or > 60 years old
• Pregnant
• Difficult airway (e.g. short chin, OSA, morbid obesity)
  Loose tooth

Medical conditions

• Overt GI bleeding
• Uncontrolled hypertension (BP > 180/100)
• Severe cardiopulmonary disease
• Has cardiac device (e.g. cardiac pacemakers, defibrillators, stents, heart valve replacements)
• Recent AMI / CVA within 6 months

Specific medications

• Diabetic on insulin
• On dual antiplatelet therapy
• On anticoagulation: warfarin and NOAC medications (e.g. dabigatran, rivaroxaban, apixaban, edoxaban) ​

• Rectal bleeding
• ​FIT +ve
• Family history (1st degree relative) of colorectal cancer
• Polyp surveillance (based on previous instructions from scopist)

Patient characteristics

• Unable to give consent < 21 years old, or > 60 years old
• Pregnant
• Difficult airway (e.g. short chin, OSA, morbid obesity)
• Last Colonoscopy done within 2 years

Medical conditions

• Overt GI bleeding
• Abdominal pains
• Ignificant loss of weight Uncontrolled hypertension (BP > 180/100)
• Severe cardiopulmonary Disease
• Severe, unstable ischaemic heart disease
• Has cardiac device, e.g. cardiac pacemakers, defibrillators, stents, heart valve replacements
• Recent AMI / CVA within 6 months
• Moderately severe to severe chronic kidney disease

Specific medications

• Diabetic on insulin
• On anticoagulation: warfarin and NOAC medications (e.g. dabigatran, rivaroxaban, apixaban, edoxaban)

• Carpal tunnel syndrome
• De Quervain’s Tenosynovitis
• Trigger finger
• Wrist pain or soft tissue injury
• Osteoarthritis of the hand/ wrist
• Finger/ thumb pain or soft tissue injury

• Fracture
• Tendon injury
• Brachial Plexus Injury (BPI)
• Thoracic Outlet Syndrome (TOS)

• Children age 3 and above
• Difficulty pronouncing words
• Motivated to engage in assessment and/or therapy

• Children younger than 3 years old
• Children diagnosed with Developmental Language Disorder,
  Language Disorder, Voice Disorder
• Children diagnosed with developmental conditions listed in the DSM-5 – for example, Autism Spectrum Disorder (ASD), Intellectual Disability (ID), Global Developmental Delay (GDD), Selective Mutism (SM), Attention Deficit Hyperactivity
  Disorder (ADHD), Social Communication Disorder (SCD).
• Children with Cleft and Craniofacial Disorders
• Children with genetic syndromes such as Down syndrome or Fragile X syndrome
• Children with suspected neurological
  disorders such as Cerebral Palsy

• Individuals aged 3 years and above
• History of developmental stuttering beginning in childhood
• Stuttering persists into adulthood
• Motivated to engage in assessment and/or therapy

• Acquired neurogenic stuttering following stroke, TBI, Parkinson’s disease, etc.
• Psychogenic/ functional stuttering
• Significant cognitive impairment
  preventing participation

• Adults aged 40 years and older
• Progressive deterioration in language abilities over time (e.g., word-finding
  difficulties, reduced speech output,
  impaired sentence comprehension)
• Symptoms present for at least 3-6 months
• Individual remains medically stable and
  able to participate in outpatient assessment and therapy
• Diagnosis of PPA already established
  by a neurologist/ geriatrician, or strong
  suspicion of PPA

• Acute or subacute neurological injury,
  including: Stroke, Traumatic brain injury, Brain tumour, Encephalitis
• Sudden onset of language impairment
• Co-presence of swallowing, speech and voice problems not previously managed by an ST
• Significant behavioural or psychiatric
  symptoms preventing participation

• Individuals who are 18 years and above.
• Non-malignant persistent pain that has lasted 6 months or more and impacts
  on patient’s daily functioning and/ or
  mood.
• Adequate trials of medical, physical, or interventional treatments over the past 12 months without sufficient relief.
• Pain substantially disrupts daily
  activities, including work, relationships,
  sleep, or exercise.
• Patient exhibits reactive mental health symptoms such as anxiety, depression, fear avoidance, or frustration directly
  linked to their pain.
• Concerns about medication reliance,
  adverse side effects.
• Patient expressed readiness and willingness to actively learn coping skills, cognitive behavioral strategies, and lifestyle adaptations to live well with their pain.

• Patient is actively suicidal with high risk of self-harm and harm to others.
• Patients with active, severe psychiatric crises (e.g., severe untreated psychosis) that impede their ability to engage in psychological therapy may require prior
  psychiatric stabilization.
• Patients who strictly desire a “search-and-fix” biomedical cure and firmly refuse to engage in habit, lifestyle, or
  behavioral changes.
• Severe, untreated substance use disorders may require specialized addiction treatment before chronic pain psychology can be effective.
• Addictions/ untreated substance use.
• Significant expressive and/ or receptive
  language difficulties, such as Primary
  Progressive Aphasia (PPA).
• Patient is only conversant in a dialect or language that requires an interpreter, and a suitable interpreter is unavailable.
• Patient is unable to give permission/ expresses unwillingness for referral for therapy.
• Patient is involved in ongoing/pending
  litigation.

• Individuals who are 18years and above.
• Patient has mild to moderate symptoms of depression/ anxiety.
• Patients with low motivation/ anhedonia that could be attributed to
  underlining mental health issues.
• Difficulty coping with the impact of
  a medical diagnosis (e.g. malignancy),
  psychological sequelae with moderate to severe symptoms secondary to managing their medical condition (not related to social/ family or financial
  stressors).
• Sleep difficulties with request for psychological support without ongoing need for psychotropic medications.

• Patient is actively suicidal with high risk of self-harm and/or harm to others.
• Patients with active psychiatric follow-up.
• Patients in crisis (e.g. untreated psychosis) that impede their ability to engage in psychological therapy and may require prior psychiatric stabilization.
• There is underlining addictions/ substance abuse.
• Patient has significant expressive and/ or receptive language difficulties, such as Primary Progressive Aphasia (PPA). Psychological interventions typically
  require understanding and expression
  of language to be successfully conducted.
• Patient is only conversant in a dialect or language that requires an interpreter, and a suitable interpreter is unavailable.
• Patient is unable to give permission/ expresses unwillingness for referral for therapy.
• Patient is involved in ongoing/ pending
  litigation.