** This clinic is held at both locations, please select both sites** Dear All,
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1 Dear All, Important Announcement We have made changes to our Ear, Nose s to enable referrals to be received in the correct clinics. This should also assist with the appointment slot issues (ASIs) we have experiencing for this service as we get a large proportion of referrals sent to us using the clinic type Not Otherwise Specified. Please note that some of these services run across sites so locations when referring patients. A larger proportion of ENT clinics take place at. How to find the services in Choose and Book? You can find these services by choosing the following: Ear, Nose Various (see each service below for mappings This service is restricted to 16 years and over and is for Routine Urgent referrals. Please can you ensure that the referral letter is attached within 24 hours for urgent referrals and within 3 days for routine referrals. CAB Specialty/ Type Conditions treated/ is suitable for patients with Ear Adult Ear sites** General Otology (Ear) Conditions including: Simple ear pain / recurrent, External otitis/ eczema of the ear, Itchy ears, Pressure in the ear, Hearing loss with or without tinnitus, Recurrent ear infections, Minimal dizzy symptoms Please DO NOT refer perforated ear drum into this clinic (use the Specialist clinic). Patients with the following problems: Nose/ Sinus; Balance/ Dizziness; Facial Plastic and Skin Lesions; Snoring (not Sleep Apnoea); (inc Voice/ Swallowing); Neck lump/ thyroid; salivary gland; General Nose / Please do not refer into this clinic or the referral will be rejected. Referrals for hearing aids should be sent directly to Audiology. Wax removal that can be carried out in primary care or nurse clinic. Specialist Ear ENT updated communication to GPs 04/03/2014 1
2 Type Ear sites** Conditions treated/ is suitable for patients with Chronic middle ear disease with suspected cholesteatoma, Perforated ear drum, Congenital deafness, Ménière's disease, Deafness moderate to severe, Patients needing special treatment with cochlear implant and other implants, Purulent persistent ear discharge. Referrals for hearing aids should be sent directly to Audiology. General / simple Ear problems, e.g., pressure in ear, recurrent ear infections. Nose/ Sinus General Nose Sinus sites** General Rhinology conditions, including, All general nasal disorders, All general sinus disorders, Common allergic rhinitis, Simple nasal runny nose, Headaches/ pressure in nose face, Sinus pressure, Straight forward deviated nasal septum/ turbinate, Sneezing / itchy nose, Loss of smell, Nose bleeds, Medical rhinology, Nasal polyp. Ear; Facial Plastic and Skin Lesions; Snoring (not Sleep Apnoea); (inc Voice/ Swallowing); Neck lump/ thyroid; Salivary Gland. General ENT Please do not refer into this clinic or the referral will be rejected. Snoring (not Sleep Apnoea) ENT Snoring The clinic is only for people with snoring related conditions Snoring, mandible problems, nasal airway symptoms, Snoring (with no suspicion of OSA), Epworth Sleepiness score <10. ENT updated communication to GPs 04/03/2014 2
3 Type sites** Conditions treated/ is suitable for patients with Ear; Facial Plastic and Skin Lesions; Nose/ Sinus ; (inc Voice/ Swallowing); Neck lump/ thyroid; Salivary Gland; General sleep disorders, obstructive sleep apnoea, Other ENT conditions where primary complaint is not snoring; General ENT Please do not refer into this clinic or the referral will be rejected. (inc Voice/ Swallowing) General sites** General conditions including: Tonsillitis, Sore throats, Pharyngitis, Pain on swallowing, Difficulty swallowing, Feeling of lump in throat, Gastrooesophageal reflux effect in throat, Globus sensation, Simple neck lump (NO THYROID OR PAROTID OR SUBMANDIBULAR gland to be referred here). Also consider the following: Recurrent tonsillitis, inflamed tonsils, enlarged tonsils, tonsillitis throat infection, dysphagia, gastro oesophageal reflux, laryngeal aspiration, pharyngeal pouch, swallowing disorders. (not Sleep Apnoea); Neck lump/ thyroid; Salivary Gland; General ENT Please do not refer into this clinic or the referral will be rejected. Thyroid or Parotid or Submandibular glands. Balance/ Dizziness ENT Balance Dizziness, giddiness, imbalance, dysequilibrium, vertigo, peripheral vestibular dysfunction, central vestibular disorders, benign paroxysmal positional vertigo (BPPV), positional vertigo, migraine related vertigo, visual vertigo, hyperventilation syndrome associated dizziness, autoimmune inner ear disease, motion sickness, mal de ENT updated communication to GPs 04/03/2014 3
4 Type Conditions treated/ is suitable for patients with debarquement. General ENT Please do not refer into this clinic or the referral will be rejected. Patients with the following problems: Nose/ Sinus; Ear; Facial Plastic and Skin Lesions; Snoring (not Sleep Apnoea); (inc Voice/ Swallowing); Neck lump/ thyroid; Salivary Gland; Patients with acute dizziness, syncope or loss of consciousness. Nose/ Sinus Facial Plastic and Skin Lesions Rhinology (Nose) Facialplastic Clear nasal polyp, Deformed nose (including post traumatic), Purulent nasal discharge, Frank chronic sinusitis where surgery may be needed after failed trials of medical therapy, needing further imaging, All types of 'unhappy' external appearances, needing facial plastic surgery, Persistent nasal obstruction refractory to medical treatment, Patients needing more attention than being seen in general adult clinic, Nasal mass, suspected nasal neoplasm's, CSF rhinorrhoea. Patients with the following problems: Ear; Balance/ Dizziness; Snoring (not Sleep Apnoea); (inc Voice/ Swallowing); Neck lump/ thyroid; Salivary Gland; General ENT Please do not refer into this clinic or the referral will be rejected. Neck lump/ thyroid Simple Neck Lumps (Not Thyroid) Simple neck lumps, feeling of lump in throat. Please DO NOT refer THYROID OR PAROTID OR SUBMANDIBULAR gland to this clinic. ENT updated communication to GPs 04/03/2014 4
5 Type Conditions treated/ is suitable for patients with (not Sleep Apnoea); (inc Voice/ Swallowing); Salivary Gland; General ENT Please do not refer into this clinic or the referral will be rejected. Salivary Gland Salivary gland lesions, recurrent salivary gland swelling, Enlarged lymph nodes. Salivary Gland (not Sleep Apnoea); (inc Voice/ Swallowing); Neck lump/ thyroid; Skin Lesions, Thyroid; General ENT Please do not refer into this clinic or the referral will be rejected. Advice Guidance (AG) Please note that the AG facility within CAB is also available for GPs to use. When using Advice and Guidance, please remember that you will need to use CAB web based using it via your clinical systems does not reveal the information to us otherwise, please use the free text box. Please contact me directly if you have any further queries regarding our Choose and Book services. Please kindly forward this to your colleagues who may find this useful. Thank you for your patience in awaiting the amendments of this service on Choose and Book. Kind Regards Arti Trivedi Choose and Book Project Manager 4th Floor, South Wing, Block B St Thomas' SE1 7EH Tel: (Internal: 80823) Fax: (Internal: 80825) arti.trivedi@gstt.nhs.uk ENT updated communication to GPs 04/03/2014 5
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