ENT referrals

This page provides guidance for GPs referring to ENT services at Fiona Stanley Hospital.

Further information regarding primary care management of ENT conditions is available on HealthPathways WA (external site) however, you will need a HealthPathways login to access this information. Please email healthpathways@wapha.org.au to obtain login details.

HealthPathways are currently working on responding to the ENT referral criteria implemented in July 2017 and will have all the ENT pathways adapted to WA as soon as possible.


Rapid Access Neck Lump Clinic referrals
The FSH Rapid Access Neck Lump Clinic is a 'one-stop' clinic to diagnose head and neck tumours as early and as quickly as possible. We aim to see all referred patients within 2 weeks of referral. 

It is important that GPs refer patients who meet the criteria as quickly as possible.

Referral criteria

Patients must be aged 16 years or older and have one or more of the following symptoms:

  • Any neck lump persisting for more than 3 – 6 weeks.
  • Any unexplained persistent swelling of the parotid or submandibular gland.
  • Thyroid swelling in association with any of the following:
    • a solitary nodule increasing in size
    • a history of neck irradiation
    • a family history of an endocrine tumour
    • unexplained hoarseness or voice changes
    • cervical lymphadenopathy.

Exclusions

Patients with suspected head and neck cancer that does not present with a neck lump (criteria above) must be referred by contacting the on-call ENT registrar via the FSH Help Desk on 6152 2222.

Referral instructions

Referrals to the clinic must follow the process below.

  1. Referrals must be submitted using the WA Health General Adult Referral Form (external site).
  2. Referrals must include documentation of the referral criteria that has been met and a relevant medical history.
  3. Fax referrals directly to FSH Referrals on 6152 9762 marked 'Urgent referral to Rapid Access Neck Lump Clinic'.
  4. Advise the patient that if the referral is accepted they will be offered an appointment and will need to prepare to be at FSH for the whole day.
  5. Print the FSH Rapid Access Neck Lump Clinic patient information page and give to the patient.
Note: for patients who meet the above criteria no additional investigations are required.

Follow-up

Some patients will require panendoscopy and biopsy under general anaesthetic and will be booked accordingly.

Patients indicated for urgent treatment will be booked into the next available Head and Neck Multidisciplinary Team Clinic.

Patients who are found not have suspicious disease or who do not require urgent treatment will be either referred back to their General Practitioner (GP) or appropriately triaged to a routine outpatient clinic.

The referring GP will receive a letter describing the outcome of the assessment and the provisional plan.

Clinic contact details

Contact the Head & Neck Nurse in the Ear Nose and Throat Clinic between 8:30am–4pm, Monday to Friday. 

Phone 6152 2222 and the FSH Helpdesk will connect you.


Routine ENT referrals

To ensure adult patients access timely and appropriate management of non-urgent ENT conditions, referrals to the Central Referral Service (CRS) (external site) for specialist services for patients over 16 years of age will be assessed using the referral criteria outlined below. 

Only referrals requiring specialist level care will be accepted. 

The criteria for routine referral for the following conditions have been reviewed:

Referrals for patients who do not meet the criteria will be returned for ongoing management in the community but may be re-referred if the condition becomes appropriate for specialist review. 

In addition to standard CRS referral information (external site), referrals must contain sufficient information to enable clinical triage against the ENT referral criteria listed above.

Indications for urgent referral are included. If an urgent referral is required the GP should:

  • phone the on-call FSH ENT Registrar via the hospital switchboard on 6152 2222
  • fax the urgent referral directly to FSH Referrals on 6152 9762.

Paediatric referrals

The ENT referral criteria for paediatric patients are currently being reviewed. 

Exclusions that apply to all paediatric ENT referrals are:

  • neonates (less than 3 months old) 
  • child weight < 10kg - if there is no weight recorded, then if the child is less than 12 months old, they should be referred to PMH.
  • requires paediatric nasendoscopy
  • paediatric patients with severe congenital, developmental syndromes

Referral criteria for tonsillitis is applied to ENT referrals for paediatric patients, as per the published CRS tonsillitis criteria (external site).

This information will be updated when criteria for additional conditions are reviewed.