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This guidance covers the referral of a patient who presents with symptoms suggestive of head and neck or thyroid cancer to an appropriate specialist or the neck lump clinic, depending on local arrangements.
GPs can refer a patient they suspect of having cancer to be seen within 14 days by a specialist. GPs must send the referral within 24 hours of the decision to refer.
Please note: suspected cancer ENT and Thyroid referrals need to be referred to the Royal Devon and Exeter using the forms below. These referrals will need to be made through the e-referral system as Royal Devon and Exeter do not accept faxed referrals.
Northern Devon Healthcare Trust will continue to receive suspected cancer referrals for Maxillo-Facial referrals which will be received in the usual manner; either e-referrals or via Fax.
Please use the referral forms listed on this page to ensure appropriateness. They have been agreed by the Peninsula Cancer Network
With the exception of persistent hoarseness, investigations are not recommended as they can delay referral.
Thyroid Cancer Investigations
Primary care initiation of investigations such as ultrasonography or isotope scanning is not recommended.
Request thyroid function tests in patients with a thyroid swelling without stridor or any of the features listed below.
Refer patients with hyper or hypothyroidism and an associated goitre, non-urgently, to an endocrinologist. Patients with goitre and normal thyroid function tests without any of the features listed above should be referred non-urgently.
With the exception of persistent hoarseness, investigations are not recommended as they can delay referral.
Suspected Head and Neck Cancer - General:
Suspected Head and Neck Cancer – Ear, Nose and Throat Origin:
Suspected Thyroid Cancer:
It would be very helpful if a thyroid function test result less than 8 weeks old could be provided
Please note: suspected cancer ENT and Thyroid referrals need to be referred to the Royal Devon and Exeter using the forms below. These referrals will need to be made through the e-referral system as Royal Devon and Exeter do not accept faxed referrals.
Suspected Head and Neck Cancer – Oral Maxillo-Facial Origin
Please note: unilateral sensorineural hearing loss is not a symptom of head and neck cancer. Please refer patients with this symptom via the normal channels.
Please note: Northern Devon Healthcare Trust will continue to receive suspected cancer referrals for Maxillo-Facial referrals which will be received in the usual manner; either e-referrals.
The GP should use e-Referral Service to book an appointment or send referral.
Please ensure you include: -
e-Referral selection:
Please ensure that referrals are booked via NHS e-Referral Service. If no slots are available please defer to provider and the NDDH or RD&E will book the appointment and contact the patient. Please also ensure that referral letters are attached to the system within 24 hours to enable us to book pre appointment tests and scans timely.
Suspected Head and Neck cancer referral form - No merge fields
NICE referral guidelines for suspected cancer
Suspected Cancer Guidelines A-Z
NICE referral guidelines for suspected cancer
bmj - New NICE guidance on referral for cancer
bmj - Assessing and referring adult cancers infographic
New Leaflet available for patients who are referred to exclude a diagnosis of cancer
New Leaflet available for patients who are referred to exclude a diagnosis of cancer
This guideline has been signed off by NHS Devon.
Publication date: November 2016