For urgent paediatric ENT referrals that cannot wait for routine treatment.

As you are aware Communitas have been providing ENT services across North East London for several years, including Barts Health.

However, there are Paediatric Emergency Services at Royal London Hospital (RLH) site that are still available on eRS.   These services will be closed on eRS and replaced with email triage service as of 8th December 2023 for Paediatrics as below to align with other Barts Health sites.

Service line closure on eRS for RLH as of 8th December 2023 is:  

• Emergency Paediatric ENT RAS (RLH) Barts Health NHS Trust - R1H

Replacement service at RLH for Adult and Paediatrics is:

• The new service is a 2 day email triage service and the referral will need to be sent to bartshealth.ENTreferralsRLH@nhs.net (referral template in downloads)

Eligibility criteria

Inclusions

• Unresolving otitis external or otitis media
• Sudden sensorineural hearing loss
• Foreign bodies in the ear/ nose
• Acute facial palsy
• Fractured nose, within 5 days (WITHOUT septal haematoma)
• Recurrent epistaxis
• Acute TM injury
• Acute neck swelling

FOR ANY GUIDANCE AND ADVICE PLEASE CONTACT THE ON CALL TEAM VIA SWITCHBOARD

Exclusions

• Unexplained neck lump
• Persistent hoarseness >3 weeks
• Throat pain>4 weeks in >40 yr olds
• Sero-sangiunous nasal discharge > 3 weeks
• Unilateral purulent nasal discharge (not FB related)
• Orbital mass• Not resolving severe facial pain
• Lesion /suspicious lump or red/white patches in lip/oral cavity (consider Maxfax)
• Poor healing in oral cavity >3 weeks (consider MaxFax)

FOR ANY OF THE ABOVE – GP SHOULD BE ADVISED TO REFER VIA SUSPECTED H&N CANCER (2WW)OTHER CASES

• Ear wax – GP should refer to Nurse-Led Aural Care (Microsuction) Clinic or a General ENT Clinic

Very acute referrals – SEND TO A&E- Examples:

• Epistaxis
• Acute mastoiditis
• Unable to eat & drink
• Breathing difficulty

Chronic problems (>6 weeks) - refer to Consultant-led ENT clinics- Examples:

• Recurrent ear/sinus/throat infections
• Decreased hearing
• Dysphonia
• Nasal obstruction

How to refer

The following clinicians can refer to this service: