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.

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, reside in the South Metropolitan Health Service (external PDF 2MB) or East Metropolitan Health Service catchments 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.
Note: for patients who meet the above criteria no additional investigations are required. The aim is to get indicated patients into the clinic as quickly as possible.

Exclusions

  • Known or previous head and neck cancer diagnosis*
  • Patients with suspected head and neck cancer that does not present with a neck lump*
* These patients can 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.

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 subsequent 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 patients access timely care and appropriate management of their conditions the WA Health ENT services will only accept referrals suitable for specialist care. 

Criteria for adult referrals have been in place since July 2017. 

From 1 December 2018 criteria will be applied to paediatric referrals for the conditions described below. 

Please note the Fiona Stanley Hospital exclusions that apply to all paediatric ENT referrals (these should be directed to Perth Children’s Hospital):

  • 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 Perth Children's Hospital
  • requires paediatric nasendoscopy
  • paediatric patients with severe congenital, developmental syndromes.
This section provides the instructions for specific conditions where referral criteria is required to be met.
Referrals will continue to be submitted to the Central Referral Service using the general adult or paediatric referral forms

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 and 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.