Nurse-led 'one stop' clinic for elective tonsillectomy referrals

Objectives: Balancing new referrals with limited clinic capacity is a challenge. At Lincoln County Hospital, referrals for tonsillectomy have been managed by an experienced ENT nurse practitioner, in order to deal with this problem more effectively. We reviewed tonsillectomy referrals made in a one year period to determine if surgical outcomes were satisfactory. Results were compared with figures available from the national prospective tonsillectomy audit. Methods: This was a retrospective study, assessing patients referred to the ENT department at Lincoln County Hospital. We reviewed the number of patients who had proceeded to surgery and the rate of complications. Results: One hundred and fifty-nine patients had been referred for tonsillectomy over the one year period. One hundred and forty-seven patients had been seen in clinic and 12 had not attended their clinic appointment. Following consultation with the nurse practitioner, 125 patients had proceeded to surgery. Five episodes of bleeding were recorded as complications postoperatively; giving a bleeding complication rate of 4.7 per cent, compared with a rate of 5.7 per cent from the national prospective tonsillectomy audit. Conclusion: A trained nurse practitioner can safely and effectively facilitate the complete process of managing a routine pre-operative tonsillectomy patient, from primary care referral to arranging admission for surgery.