If you have an urgent problem requiring immediate surgical assessment you are referred acutely to the ORL-HNS Department where you will initially be seen by the Registrar (a trainee specialist) who will assess you. Investigations will be performed as required. The results of this evaluation will determine whether you need to be admitted to hospital. More senior members of the ORL HNS Department, such as Consultants and/or Fellows, will be involved in your care as necessary.
If the problem is not urgent, the GP will write a letter to the ORL-HNS Department requesting an appointment in the outpatient clinic. Each month the Department receives more new referrals than can be seen in clinic. Consultant surgeons working in the Department review the referral letters to determine who should be seen, and the urgency of the referral, based on the information provided by the GP. Very urgent cases are usually seen within a couple of weeks, but other cases may have to wait a much longer time. Routine cases are often returned to the GP with some management advice.
When you come to the ORL-HNS Outpatient Department you will be seen by a member of the ORL-HNS team who will ask questions about your illness and examine you to try to determine or confirm the diagnosis. This process may also require further tests (e.g. blood tests, x-rays, scans etc). Sometimes this can all be done during one clinic visit, but for some conditions this will take several follow-up appointments. Occasionally some tests are arranged even before you are seen at the hospital to try to speed up the process.
Once a diagnosis has been made, the medical staff will discuss treatment with you. In some instances this will mean surgery, while other cases can be managed with medication and advice. If surgery is advised you will be put on the elective surgical waiting list. Again these waiting lists are ordered according to the urgency and severity of the condition. The steps involved in the surgical process and the likely outcome are usually discussed with you at this time.
In order to minimise the amount of time of that you have to spend in hospital, many surgical departments run a preadmission process. This is usually done through a clinic where you are seen just prior to hospital admission. The aim of this clinic is to confirm that you still need to have the planned surgery and that you are currently fit and well enough to undergo the operation. This process usually involves the junior medical staff working in consultation with the anaesthetists, pharmacists, physiotherapists etc. Often the consultant surgeon will also take this opportunity to review your condition.