ENT Referrals
Overview
Comprehensive guidance for ENT referrals at Wigan Central, including routine pathways, urgent referrals, and advice & guidance services.
🕐 Current Waiting Times
| Service | Waiting Time | Notes |
|---|---|---|
| Routine ENT | ~12 months | ENT are running ‘Super Clinics’ on Saturdays to reduce backlog |
| Audiology | ~20 working days | Very short waiting list |
| Emergency ENT | Same day | Phone assessment required - see Acute ENT Referrals |
Use Audiology Where Possible
Due to long ENT waits, consider whether Audiology can manage the condition instead. Audiology can now see unilateral hearing loss (if ear appears normal) and can arrange MRIs if needed.
📋 Advice & Guidance (A&G)
Use A&G Before Referring
ENT responds to A&G queries within 2-3 working days. This service is highly recommended to:
- Confirm the most appropriate referral destination (ENT vs Audiology vs specialist clinic)
- Determine urgency (routine vs urgent vs emergency)
- Avoid inappropriate referrals that may wait 12 months before triage
A&G Benefits
| Benefit | Description |
|---|---|
| Correct routing | ENT converts appropriate A&G queries into referrals and places patients in the correct clinic |
| Faster access | Patients may be directed to specialist clinics with shorter waits |
| Avoid delays | Referrals aren’t triaged until reaching the top of the queue - A&G prevents inappropriate referrals waiting 12 months |
Accessing A&G
Secretaries can use A&G at their discretion to redirect referrals to more appropriate pathways (e.g., specialist clinics instead of general ENT).
🏥 Specialist Clinics
ENT runs several specialist clinics that may offer shorter waiting times:
| Clinic | Description | When to Use |
|---|---|---|
| One Stop Head & Neck Clinic | Joint appointment with ENT consultant, radiologist, and biomedical scientist. USS performed and interpreted during appointment. | Mainly for 2WW referrals |
| One Airway and Voice Clinic | Joint clinic with ENT and Respiratory | Complex upper airway and voice disorders |
| Super Clinics | Saturday clinics seeing ~100 new patients | Routine new patients only |
Pathways Coming Soon
ENT are creating flowcharts/pathways for all referral types, which will be published on the GM Primary Care Portal within the next few weeks.
🔁 Post-Operative Complications
Direct Patients to ENT Clinic
All post-operative ENT patients receive a discharge pack containing:
- Details of their surgery
- Potential complications to watch for
- Direct contact number for the ENT team
Do not see post-op patients at the GP surgery. Direct them to contact the ENT clinic directly using the information in their discharge pack.
⚡ Expedite Requests
Expedite Policy
ENT will not accept expedite requests unless there has been:
- Significant worsening of symptoms, OR
- Change in symptoms (new symptoms developing)
Examples of Inappropriate Expedite Requests
| Scenario | Why Inappropriate |
|---|---|
| Patient awaiting tonsillectomy continues having tonsillitis episodes | Expected to continue having symptoms while waiting |
| Patient wants to move up the queue without clinical deterioration | No clinical justification |
Managing Patient Expectations
When patients contact ENT secretaries and are told about waiting times, they may be advised to ask their GP for an expedite letter. Unless there is genuine clinical deterioration, do not provide these letters.
📝 Referral Decision Guide
| Condition | Refer to | Notes |
|---|---|---|
| Unilateral hearing loss | Audiology | If ear looks normal (no perforations, etc.) |
| Unilateral tinnitus | ENT | Audiology cannot see unilateral tinnitus |
| Sudden sensorineural hearing loss | ENT | Urgent - requires ENT assessment |
| Perforated tympanic membrane | ENT | Audiology cannot see |
| Cholesteatoma | ENT | Requires specialist management |
| Gradual age-related hearing loss | Audiology | Direct referral |
| Bilateral symmetrical hearing loss | Audiology | Direct referral |
| Balance problems / dizziness | ENT | Refer to MDT Clinic |
| Head & Neck 2WW | One Stop Head & Neck Clinic | Via 2WW pathway |
| Routine ENT issues | ENT | Use A&G first to confirm appropriateness |
📚 Resources & Updates
| Resource | Description |
|---|---|
| GM Primary Care Portal | Register for pathways and updates (all future information will be shared here) |
| Audiology Referrals | Full audiology referral guidance |
| Acute ENT Referrals | Emergency ENT referral process |
Upcoming Pathways
ENT are developing pathways for allergies and rhinitis which will enable GPs to request specific allergy blood tests. These will be available soon.
🚨 Emergency Referrals
For emergency ENT appointments requiring same-day assessment (e.g., for microsuction/infusion of antibiotic ointments), see Acute ENT Referrals.