Central Sydney Immunology Decision pack — draft for discussion

Doctor Decisions Meeting

Safest minimum launch model and opening-readiness gates

Snapshot date

1 August 2026

First-patient target

Wednesday, 11 November 2026

Meeting logistics

Date: 01/08/26 · Time: 1:00pm · Duration: 45–60 min (editable) · Location: Online

Attendees

JL · FL · RY

Meeting outcomes

What this meeting must decide

Confirm the day-one clinical scope.

Define which procedures can activate and under what gates.

Confirm the referral-to-booking workflow.

Approve the billing architecture or record remaining exceptions.

Approve the role framework in principle and send drafts to HR/legal review.

Confirm the public-information approval queue and next owners.

Decision, defer, or assign a clear next step. Do not leave a provisional item looking final.

Decision discipline

How we categorise every decision

Confirmed

Approved and ready to operate on.

Open or provisional

A working position, pending doctor sign-off.

Safety-critical gate

Cannot proceed until explicitly cleared.

Deferred

Out of scope for this launch, by choice.

Working assumptions are useful for planning, but they do not authorise clinical delivery, public claims, booking, or implementation.

Source hierarchy

Doctor Decisions — approvals→ Launch Tracker — implementation tasks→ SOPs & Runbooks — operating procedures→ Repository/public site — deployable public facts→ Gentu — patient-identifiable clinical information

Launch spine

A confirmed core, an expansion that stays gated

Confirmed

Wednesday sessions
9:00am–4:00pm
Both doctors from launch
Consultations as the core service
Referral-first / request-to-book
External pathology only

Still gated

Testing pathways
Injection pathways
Emergency readiness
Staff role allocation
Fees and payment wording
Public website wording

Referral→ Doctor review→ Approved appointment type→ Consultation→ Controlled expansion

Not every candidate procedure is available on day one.

Open decision register

Five decisions need action today

Decision ID Decision Area Status Needed from

DEC-09Approve fee schedule and billing policyFinanceNot startedDoctors

DEC-11Confirm procedure room go/no-go criteriaClinical modelIn progressFL / JL

DEC-12Approve patient-facing website and referral wordingMarketingNot startedFL / JL

DEC-13Confirm day-one clinical service scopeClinical modelIn progressFL / JL

DEC-18Approve CSI role framework and position descriptionsOperationsNot startedJL / FL / RY

DEC-02 and DEC-10 are recorded as done and should be treated as the current operating rule unless the doctors explicitly reopen them.

DEC-13 · Clinical model · Decision 1 of 6 In progress

"What exactly can Central Sydney Immunology offer from the first patient day?"

Preferred working assumption

Consultations plus selected procedures from day one, subject to individual clinical readiness gates.

Core launch

Adult allergy consultations
Paediatric allergy consultations
Adult clinical immunology consultations
Paediatric clinical immunology consultations
External pathology referrals

Candidate gated services

Skin-prick testing
Selected biologic injections
Selected subcutaneous immunotherapy

Explicitly deferred

Food and drug challenges
Infusions
On-site pathology collection
Multi-specialty consulting

Unlocks: procedure pathways, SOPs and readiness evidence · Source: Doctor Decisions — DEC-13

Selected option

—

Owner

—

Effective date

—

DEC-11 · Clinical model · Decision 2 of 6 In progress

"Which procedure pathways can activate, and what must be true before activation?"

Current record

Skin-prick testing and biologic injections appear in the populated final-decision field
Formal scope and activation criteria remain unresolved
Selected SCIT appears in the broader provisional clinical model and requires explicit confirmation

Do not present the populated final-decision field as approved while the record remains "In progress."

Required activation gates

Approved clinical pathway Defined eligibility and exclusions Doctor availability Trained staff present Emergency equipment present and checked Observation period defined Escalation pathway defined Discharge documentation defined Cleaning and room-reset process ready Incident and results documentation ready

Unlocks: procedure pathway go-live · Source: Clinical Operating Model — DEC-11

Selected option

—

Owner

—

Effective date

—

DEC-02 / DEC-10 · Operations · Decision 3 of 6 Confirmed operating rule — ratify only if changed

Referral triage and booking

Referral received→ Minimum information checked→ Missing information requested→ Doctor review→ Accept, redirect or decline→ Patient contacted→ Appointment confirmed

Every referral is reviewed by a doctor before booking
No clinical appointment is confirmed before doctor approval
Urgent referrals go directly to a doctor before booking
Incomplete or unclear referrals are held while missing information is requested

Either doctor may accept or redirect using shared criteria
Existing valid referrals may be accepted for the same specialist and ongoing course
A new referral is requested if expired, ambiguous, addressed to another clinician, or for a new problem
The clinic will manage the process internally for now

Reception can acknowledge and coordinate; reception does not interpret clinical urgency or provide clinical advice.

Unlocks: intake form, doctor review queue, booking workflow · Source: Reception, Referrals & Booking

Ratified as-is

—

Owner

—

DEC-09 · Finance · Decision 4 of 6 Not started

"Approve the shared billing architecture and identify the remaining fee decisions."

Current provisional recommendation

Each doctor sets and approves their own consultation fees One shared CSI cancellation, no-show and deposit policy Fixed $100 refundable attendance deposit after doctor approval, before confirmation Deposit credited toward the consultation fee Refunds, transfers or retention only under the disclosed policy Tyro Health for online deposit links and in-person payments One Tyro terminal at reception Remaining balance collected at reception on appointment day

Medicare claim processed after the consultation and payment workflow.

Unresolved

Final fee schedule
Notice period
Detailed cancellation/DNA wording
Final public-facing fee language

Verify the final policy against current billing, consumer-law and medical-indemnity advice before implementation.

Unlocks: patient wording, deposits, Tyro and Medicare testing · Source: Billing, Medicare & Payments

Architecture approved

—

Owner

—

DEC-18 · Operations · Decision 5 of 6 Not started

"Approve the role architecture in principle and progress the drafts to qualified HR/employment review."

Current provisional model

RY leads practice management, nursing and clinic coordination
Doctors focus primarily on clinical work
A named remote administrator proposed for a fixed four-hour weekly retainer outside Wednesdays
Gentu access uses individual named accounts, task-based permissions, MFA — no shared accounts

Approvals still required

Engagement arrangement Classification Delegated authority Lead, backup, joint governance portfolios After-hours expectations Leave and support cover Credential and insurance verification Clinical sessions and availability Individual review and signatures HR/employment legal review

Position descriptions do not replace employment contracts, service/facilities agreements, credentialing, scope-of-practice approvals, or privacy documentation.

Unlocks: contracts, access controls, staffing readiness · Source: CSI role framework and position descriptions

In-principle approved

—

Owner

—

DEC-12 · Marketing · Decision 6 of 6 Not started

"What patient-facing claims can be approved now?"

Current public-surface rules

Coming Soon is the only production surface
The full immunology site remains on a protected, noindex preview surface
Public wording must match the confirmed launch model
Do not publish unapproved procedures, fees, referral claims, clinician details, or emergency wording

Approval queue

Day-one conditions and services Fee schedule, Medicare and payment wording Referral and booking rules Clinician bios and approved photos Cancellation/DNA policy Emergency and urgent-care wording Final Privacy and Terms effective dates Confirmed referral channel and canonical wording Final public opening and service wording

Doctor approval→ Implementation review→ Repository update→ Preview review→ Production decision

Unlocks: website content, preview review, production launch decision · Source: Website & Public Information

Owner

—

Next owner

—

Safety and opening-readiness gate

Nothing here is approved for clinical use yet

Anaphylaxis Response Protocol — AI DRAFT, generated 19 July 2026. Not reviewed, not approved, not for clinical or operational use.

Decisions still required

Adopt and verify current ASCIA acute-management guidance Approve the adrenaline delivery model and backup method Confirm minimum emergency competence for each session Assign response roles by capability Confirm ambulance access instructions for Suite 1103, 99 York Street Rehearse the route and record building access constraints Confirm observation, transfer, handover, incident review, replenishment processes

Non-clinical readiness evidence pending

Executed lease evidence
Gentu onboarding and commencement dates
CommBank banking verification
Staff and credentialing evidence

Source: Anaphylaxis Response Protocol

Live decision log

Capture outcomes as they are agreed

Do not record an approval without required doctor sign-off

DEC-13 — Day-one clinical service scope

Status: —Due: —