title: Do GP referral guidelines really work? Audit of an electronic urgent referral system for suspected head and neck cancer.
abstract: We adapted the 2002 Scottish Referral Guidelines for suspected squamous cell carcinoma of the head and neck (SCCHN) as a set of "alarm symptoms." These were then incorporated into a new Suspected Cancer Urgent Referral Electronically (SeCURE) system enabling immediate electronic referral from primary care to the appropriate hospital-based multi-disciplinary cancer team. All referrals made via the SeCURE system during the first year of its implementation were reviewed retrospectively. One hundred and ninety patients were urgently referred, of whom 15 (8%) were ultimately diagnosed with SCCHN. This audit demonstrated overall poor compliance with the referral guidelines. Although the electronic referral system helped for speedy clinic appointments, there was a low pick up rate of positive head and neck cancer cases. Continuing education for GPs is important and following discussion with colleagues in primary care, steps have been taken to reinforce awareness and more appropriate use of the SeCURE system.
authors: Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZN, UK. a.kennedy@nhs.net
authors: Ann-Maree
authors: AM
authors: Kennedy
authors: Abdul
authors: A
authors: Aziz
authors: Sameena
authors: S
authors: Khalid
authors: David
authors: D
authors: Hurman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D058006:General Practice / Q000592:standards*; D058005:General Practitioners; D019983:Guideline Adherence; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008485:Medical Audit / Q000379:methods*; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D006113:United Kingdom; D055815:Young Adult