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Advice & Guidance Service

Checked: 23-01-2021 by Sandi Littler Next Review: 23-01-2022

Service Overview

UHBW provide an advice and guidance services for adult patients (16 years and over) in ENT. This service should be utilised where advice is required on the management of a patient that may avoid the need for referral. It should not be used where immediate advice is required, in which case the on call teams should be contacted in the usual way.

Photos - If referring for advice about a problem of the throat or tonsils, it may be appropriate to provide photos that can be obtained by your patient. Please see this youtube video for advice on how to do this.

Requests for advice and guidance should be submitted vie e-RS and meet the following criteria:

Ongoing management of a patient (patients not currently under review or referred to either UHBristol. For requests for patients currently under review or referred, please write to the responsible consultant).
Advice on a treatment plan.
Advice on the appropriateness of a referral for their patient (e.g. whether to refer, or what the most appropriate alternative care pathway might be).
The most clinically appropriate service to refer a patient into.

The UHBW ENT team will provide advice on the following:

Further, useful, practice-based investigations and their interpretation with the most appropriate practice-based follow up.
Formal secondary care ENT referral if appropriate.
The reviewing clinician will give advice about any diagnostics that may be required to help with the future management of the patient. This should ensure appropriate use of diagnostic tests.

The Referral Service may also advise referring GPs to use this service, when appropriate, during the triage of ENT referrals to out patient clinics.

If the advice suggests that an outpatient referral is required please submit this via eReferral including the consultant advice and taking note of any existing funding policies.

Response times

The waiting time tool for BNSSG GP practices includes a section on A and G waiting times. You will need to download the document and follow the instructions to access the latest information (updated monthly). Please see the Hospital waiting times page.

UHBW ENT Advice & Guidance

Please see the ENT A&G Steps - UHB (word doc) for further guidance on how to submit a request through e-Referral.

Please process through eRS bypassing the Referral Service

Otology Advice - StMH - University Hospitals Bristol - RA7

Priority - Routine
Specialty - Ear, Nose and Throat
Clinic - Balance / Dizziness OR Ear OR Tinnitus

Rhinology Advice - StMH - University Hospitals Bristol - RA7

Priority - Routine
Specialty - Ear, Nose and Throat
Clinic - Nose / Sinus

Head and Neck Adult Advice - StMH - University Hospitals Bristol - RA7

Priority - Routine
Specialty - Ear, Nose and Throat
Clinic - Neck Lump / Thyroid OR Salivary Gland

To enable the consultants to give the best advice possible please consider the following points:

Give a clear concise history and examination findings- avoid cutting and pasting long lists of consultation notes that are not relevant to the problem in hand.
Include relevant results, investigations and recent correspondence if appropriate but avoid multiple attachments that can take time to download and make the triage process more cumbersome.
Ask a clear clinical question and avoid ambiguity.
Avoid requests for complex patients known to an individual consultant as they are unlikely to be the consultant giving the advice and may not have easy access to details of previous contacts with the patient. In these cases consider writing or emailing the relevant secretary directly.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.