An individualised clinical assessment is required to meet the identified needs of an individual, their carer and family; referral should be as required.

In addition to common issues identified in the Appendix, specific needs that may arise at this time include:

• treatment for physical symptoms such as pain, fatigue, musculoskeletal dysfunction, reduced oral intake and issues with activities of daily living
• help with the emotional distress of dealing with a potential cancer diagnosis, anxiety/depression, interpersonal problems, stress and adjustment difficulties
• guidance for financial, education and/or employment issues (such as loss of income and having to deal with travel, and accommodation requirements for rural patients and caring arrangements for other family members)
• appropriate information for people from culturally and linguistically diverse backgrounds
• allied health evaluations as appropriate.

Effective communication is essential at every step of the care pathway. Effective communication with the patient and carer is particularly important given the prevalence of low health literacy in Australia (estimated at 60 per cent of Australian adults) (ACSQHC 2013).

The general or primary practitioner should:

• provide the patient with information that clearly describes who they are being referred to, the reason for referral and the expected timeframe for appointments
• support the patient while waiting for the specialist appointment.