We aim to determine current detection rates of head and neck cancer within the regional network, whether the urgent referral service is being appropriately utilised and whether recent graduates make fewer inappropriate referrals. Method:All 2-week referrals made to OMFS at the Royal London Hospital between January and June 2013 were identified using the Somerset Cancer Registry. Details of the referral were sourced appropriately. GP demographics were accessed via the GMC online. Results:87 patients were referred urgently and 77 (88.5%) attended for consultation. Of these, 69 referrals (89.6%) were made by GPs, 7 by dentists and 1 by a nurse practitioner. Five cancers were diagnosed (6.5%). Only 42.9% of referrals (n=33) were deemed appropriate. Demographic data was available for 52 GPs and year of qualification ranged from 1977 to 2008. There was no association between the year of qualification and likelihood of an inappropriate referral (Fishers Exact Test, p=0.483). Conclusion: Our findings reveal a considerably lower detection rate compared with urgent referrals for other malignancies. The majority of fast track referrals are made inappropriately, regardless of GP experience, highlighting the on-going lack of OMFS exposure within the undergraduate curriculum. To address this, we propose focused teaching and the development of accessible resources such as smart phone applications.