Overview

Instructions
Triage


Sheet 1: Instructions

Script
Introduction to calculator
You have been referred to us by your doctor with a suspected head and neck cancer.

Owing to the coronavirus pandemic, we are trying to reduce unnecessary hospital visits for outpatient appointments to prevent the spread of the infection. We have therefore converted your appointment into a telephone consultation.

I will be asking you a series of questions about you and your symptoms, after which I will estimate the probability of head and neck cancer in your case.

This will be done using a risk calculator that we have created from over 10,000 UK patients. We will then decide whether you need to attend for a face to face consultation.
Reporting outcome of calculator


Low risk (If the outcome box is GREEN):
The risk calculator indicates that people with your type of symptoms have a very low probability of a cancer in the head and neck region. By not being seen in clinic, the chance of missing a cancer in people such as yourself is less than 2%. We will therefore bring you in for a consultation once the pandemic issues have settled.
High risk (If the outcome box is RED):
The risk calculator indicates that we will need to see you in clinic for a face to face consultation. Our team will contact you shortly to confirm this.




Usage
All H&N 2WW referrals, until further notice




Local registration
Please register this service evaulation locally following advice on the ENT UK website

Sheet 2: Triage

ID Demographics General Voice Airway Swallowing Oral Misc Outcomes

Age Gender Smoking Alcohol Unintentional weight loss Hoarseness Stridor FOSIT Sore Throat Odynophagia Dysphagia Oral swelling Oral ulcer Unexplained unilat otalgia Neck lump Skin lesion Calc result Clinician override Patient
choice
Triage
outcome
OPD Follow up
Patient ID Age Gender Do you smoke? Do you drink alcohol? Have you lost any weight without trying? Do you have a hoarse voice? Do you have noisy breathing? Do you have a feeling of something stuck in your throat? Do you have a pain in your throat? Do you have pain when you swallow? Do you have any difficulty swallowing? Do you have a new swelling in your mouth? Do you have a new ulcer in your mouth? Do you have any new ear pain? Do you have any new lumps in your neck? Do you have a new growth on your skin on your H&N? Outcome Patient advised for review? Patient agrees to/ preferences review? OPA arranged? Outcome of review Cancer at 6 months?
Example 45 Male No ≤14 units/week No No No No No No No No No No No No Low risk No Yes Urgent appointment offered Investigated Yes