Royal North Shore Hospital provides the following Gastroenterology clinics:

  • Hepatology/Liver Clinic
  • General Gastroenterology
  • Rapid Access Clinic*
  • Inflammatory Bowel Diseases (IBD)*
  • Endoscopy*

*Triaged and booked via General Gastroenterology Clinic bookings

Referral

To refer

A valid GP or Specialist referral is required for all services provided in the clinic – please visit your GP for an assessment if you feel a referral may be required. If you are a GP or Specialist wishing to make a referral, please use the below contacts.

Urgent referrals: Contact the RNSH Switchboard (9926 7111) and ask to page the on-call gastroenterology registrar.

Routine referrals: Send referral letter via email to nslhd-accreferrals@health.nsw.gov.au, or fax to (02) 9463 1065.

Mandatory referral information

All Hepatology and Gastroenterology referrals must include a consultant being referred to in RNSH outpatients. If unsure, please address to Dr Ian Norton and Associates.

All referrals must include patients details and reason for referral, finding/treatment to date, how this affects the patient, significant medical history, list of medications and relevant social information. Please indicate preferred language if an interpreter is required.

Please attach results of any relevant investigations to the referral and ensure the patient brings hard copies to their appointment. This will help avoid unnecessary duplication of tests, additional appointments and delay.

The following investigations must be completed prior to referring to the Liver Clinic:

  • LFTs, EUC, FBC, coagulation
  • HBV serology: HBsAg, anti-HBc, anti-HBs; if HBsAg is positive, test HBeAg, anti-Hbe and HBV DNA
  • Anti-HCV Ab; if positive HCV RNA (quantitative), HCV genotype
  • Liver ultrasound

Referrals with insufficient information will be returned to the GP until further information is provided to the clinic.

Urgent Cases 

If you are a GP or Specialist and feel your patient may require an urgent referral, please phone the RNSH switchboard on 02 9926 7111 and ask for the Gastroenterology and Hepatology Registrar on call or ask the patient to present to our Emergency Department. Conditions requiring urgent referral include:

  • Severe upper gastrointestinal bleeding eg Haematemesis/Melena
  • Acute/severe dysphagia
  • Large volume rectal bleeding
  • Symptomatic iron deficiency anaemia (chest pain/dyspnoea)
  • Severe bloody diarrhoea
  • Severe vomiting or diarrhoea causing dehydration
  • Acute liver failure and decompensation of chronic liver disease

Indications for referral

For referrer use only and is not intended for patients to self-diagnose. Any patients who feel they may require a referral must be assessed and referred by their GP if appropriate.

RNSH ClinicWhen to Refer
Liver Clinic
  • Cirrhosis (any cause)
  • Chronic Hepatitis B
  • Chronic Hepatitis C
    • Anti-HCV Ab positive AND HCV RNA positive
  • Non-alcoholic fatty liver disease with elevated ALT
  • Alcoholic liver disease
  • New liver lesion
  • Other: abnormal LFTs for evaluation (note mandatory referral info below)
  • Post-discharge patients


Urgent referrals

  • Decompensated cirrhosis: jaundice, ascites
  • Liver cancer (hepatocellular cancer)
  • Patients with positive HBV serology (HBsAg or anti-HBc positive) who are planned for chemotherapy/Immunosuppression
  • Pregnant women with abnormal LFTs or chronic hepatitis B (HBsAg positive)
​ Fibroscan
  • ​Chronic hepatitis C (pre-treatment)
  • Chronic hepatitis B
  • HCV-HIV co-infection
  • Non-alcoholic fatty liver disease
  • Alcoholic liver disease
  • Primary Biliary Cholangitis

Liver stiffness un-interpretable:

  • Acute hepatitis (ALT>10xULN)
  • Extrahepatic cholestasis
  • Right heart failure, hepatic congestion

Exclusion criteria:

  • Pregnancy
  • Pacemaker, implantable defibrillator
  • Cirrhosis already diagnosed by clinical, biochemical, &/or radiological methods; ascites.
General Gastroenterology
  • ​Post-inpatient review
  • Post-ED referral
  • +FOBT / Complex endoscopy
  • Inflammatory Bowel Disease
  • Colorectal cancer surveillance in high risk individuals (eg previous history of polyps, family history of colorectal cancer)
  • Dysphagia/complex neurogastroenterology
  • GI symptoms such as abdominal pain, change in bowel habit
  • Pancreatic diseases


The RNSH Gastroenterology Clinic is unable to provide a service for the following:

  • Screening colonoscopy in average risk patients (unless +FOBT)
  • Anorectal disorders (except in relation to Crohn's disease)
  • Diseases of the gall bladder (require referral to a surgeon)
  • IBS

Out of Area Referral

RNSH provides services to patients living within the Northern Sydney Local Health District. Exceptions to this are outlined below.

Resident of Northern Sydney Local Health District Catchment ​Yes - referral accepted at RNSH
Referral from other specialist, for specialist opinion​Yes - referral accepted at RNSH
Resident of other Local Health District that DOES NOT provide the clinical service e.g. rural, outer metro​Yes, but service or problem needs to be documented on referral
Continuing care of existing condition we already manage​Yes, provided existing or related condition documented on referral
Demonstrated complexity requiring services of Royal North Shore Hospital Ambulatory Care Centre​Yes but must be explicitly documented on referral
Compassionate circumstances (e.g. family proximity, staff)​Yes but must be explicitly documented on referral
Resident of other Local Health District that offers the service​Refer to your Local Health District


Check if the home address is within Northern Sydney Local Health District here: https://www.health.nsw.gov.au/lhd/Pages/lhd-maps.aspx

NSLHD consultant referral options

The following Gastroenterologists work at RNSH. They also have private rooms, which patients can be referred to and usually have a shorter waiting period. From the rooms patients still have access to the public system for endoscopy procedures at no out of pocket costs. There will likely be an out of pocket cost for the consultation at the private rooms. Similarly, Hornsby, Ryde and Northern Beaches Hospitals all have Gastroenterologists who can provide access to public endoscopy services at those facilities. 

Consultant Location of rooms
Dr Cameron Bell

Northern Specialist Centre (St Leonards)   Ph: (02) 9463 1966

Southern Highlands Private Hospital (Bowral)  Ph: (02) 4862 9400

Dr Danny StielNorthern Specialist Centre (St Leonards)  Ph: (02) 9463 1966
Dr Ian NortonNorthern Specialist Centre (St Leonards)  Ph: (02) 9463 1966
Dr Sarah ChoBerry Road Medical Centre (St Leonards)  Ph: (02) 9906 8973
Dr Stephen TattersallNorth Shore Private Hospital (St Leonards), Hunters Hill, Sydney Gastrointestinal Specialists (Eastwood)  Ph: (02) 9438 5193
Dr Neomal SandanayakeNorth Shore Private Hospital (St Leonards)   Ph: (02) 9439 7575
Dr Allison MalcolmNorth Shore Private Hospital (St Leonards)  Ph: (02) 9966 0057
Dr Philip ChangBerry Road Medical Centre (St Leonards)  Ph: (02) 9906 8973)
The Sydney Clinic for Gastrointestinal Diseases (Bondi Junction)
Ph: (02) 9369 3666
Sydney CBD  Ph: (02) 8378 1721
Dr Gordon ParkChatswood  Ph: (02) 9411 7747
Sydney Gastrointestinal Group (Eastwood)  Ph: (02) 9874 1251

Dr Brett Jones

Macquarie University  Ph: (02) 9812 3880

 Expand

Opening hours

Hepatology ClinicMon-Fri 8am-4.30pm
General Gastroenterology ClinicTues-Thurs 8am-12.30pm

Contact us

Gastroenterology: Ph: (02) 9463 1400
Liver Clinic: Ph: (02) 9463 2450

Fax: (02) 9463 1065; (02) 9463 2041

Clinic Location:
Ambulatory Care Centre
Check-in B, Level 3
Royal North Shore Hospital
Reserve Road
St Leonards 2065

Postal Address:
Department of Gastroenterology and Hepatology
Acute Services Building 4B
Royal North Shore Hospital
Reserve Rd
St Leonards 2065