Routine referral
We now offer direct access tonsillectomy for Borders and Lothians. This allows patients to be directly listed for tonsillectomy and therefore avoids an outpatient consultation. In order to be listed directly, the patient must satisfy the following criteria, recommended by NICE:
For people with severe recurrent tonsillitis (a frequency of more than 7 episodes per year for one year, 5 per year for 2 years, or 3 per year for 3 years, and for whom there is no other explanation for the recurrent symptoms), referral to an ear, nose, and throat specialist is advised as this cohort may benefit from tonsillectomy
Scenario: Management | Management | Sore throat – acute | CKS | NICE.
If you wish to list the patient for tonsillectomy please give the patient a Patient Information leaflet – Having a Tonsillectomy and complete the pro forma via SCI Gateway (St John’s Hospital/Lauriston Buildings > ENT > Direct Access Tonsillectomy)
Following receipt of the completed pro forma, the patient’s name will be placed on the waiting list for tonsillectomy. He/she will then be sent an appointment to attend our Pre-assessment Clinic 1-2 weeks before tonsillectomy.
If you are in any doubt or wish an ENT Surgeon to assess the patient in the Outpatient Clinic, please arrange a routine appointment.
Once a decision is made for tonsillectomy, this should be performed as soon as possible to maximise the period of benefit.
Tonsillectomy has an appreciable peri-operative morbidity, a complication rate of around 5% and the outcome is, as yet, undefined. Return to usual activity takes, on average, two weeks.
Criteria for Direct Access Tonsillectomy
Direct Access Tonsillectomy
- Sore throats are due to tonsillitis (i.e., tonsils are erythematous, oedematous and may have exudates)
- Episodes for at least one year
- Episodes are disabling and prevent normal function
- Seven or more well documented, clinically significant sore throats in preceding year OR
- Five or more episodes in each of the preceding two years OR
- Three or more episodes in each of the preceding three years
- This patient has been given a tonsillectomy information leaflet
- Six months watchful waiting has not resulted in significant improvement ( particularly relevant in children and teenagers)
ENT- Globus Syndrome PIL v1.0 NHSL Approved
ENT – Consensus Statement on the Mgt of Tonsil stones ENT Scotland Mar19
ENT – Patient Information Leaflet -Having a Tonsillectomy Jul 18 Approved Jan 19
ENT Throat – tonsillectomy referral form
Feeling of something stuck throat (FOSSIT) Globus – RefHelp (nhslothian.scot)
