Improving access to neck ultrasound referral and using guidance as a means of reducing demand on neck lump specialist assessment clinics

Abstract

Background: As with many services across the NHS, specialist clinics for the assessment of neck lumps are under increasing pressure. These clinics are ideally reserved for urgent suspected cancer (USC) referrals. However, confirmation of normal anatomy or benign pathology contributes to a considerable proportion of clinical resources. Neck ultrasound (NUS) is the primary imaging modality in assessment. In NHS Grampian, referral for NUS has historically not been widely publicised to general practitioners (GPs), with patients typically referred via the head and neck (H&N) service. This study aimed to reduce patient footfall to H&N clinics by improving GP direct access to NUS. This could reduce the number of patient hospital attendances; with a single NUS appointment replacing a clinic attendance, an NUS appointment and a clinic review for discussion of results and management.