If you have an urgent problem requiring immediate surgical assessment you will be referred to the ORL Department at Auckland City Hospital as acute ORL work is not done at North Shore or Waitakere Hospitals.
If the problem is not urgent, the GP will write a letter to the ORL Department requesting an appointment in the outpatient clinic. Each month the Department receives more new referrals than can be seen in clinic. One of the consultant surgeons working in the Department reviews the referral letters to determine who should be seen first, based on the information provided by the GP. Very urgent cases are usually seen within a couple of weeks, but other cases may have to wait a much longer time. Routine cases are often returned to the GP with some management advice.
When you come to the ORL Outpatient Department you will be seen by a member of the ORL team who will ask questions about your illness and examine you to try to determine or confirm the diagnosis. This process may also require a number of tests (e.g. blood tests, x-rays, scans etc). Sometimes this can all be done during one clinic visit, but for some conditions this will take several follow-up appointments. Occasionally some tests are arranged even before you are seen at the hospital to try to speed up the process.
Once a diagnosis has been made, the medical staff will discuss treatment with you. In some instances this will mean surgery, while other cases can be managed with medication and advice. If surgery is advised you will be put on the elective surgical waiting list. Again these waiting lists are ordered according to the urgency and severity of the condition. The steps involved in the surgical process and the likely outcome are usually discussed with you at this time.
In order to minimise the amount of time of that you have to spend in hospital, many surgical departments run a preadmission process. This is usually done through a clinic where you are seen just prior to hospital admission. The aim of this clinic is to confirm that you still need to have the planned surgery and that you are currently fit and well enough to undergo the operation. This process usually involves the junior medical staff working in consultation with the anaesthetists, pharmacists, physiotherapists etc. Often the consultant surgeon will also take this opportunity to review your condition.
July 2020 Update
ORLHNS grading
For many years we have accepted more referrals for a first specialist assessment (FSA) than we have had the capacity to see within the required 4 month timeframe. In order to personalise our service we undertake to respond to each referral with information to assist referrers with the ongoing management of ORL conditions including alternatives to a clinic visit. We will accept every referral on patients who have ‘red flag’ symptoms, signs or investigations of concern, but we cannot guarantee to see less urgent referrals if there are no available clinic appointments open.
It is important from a patient safety perspective that we are able to track each referral and we therefore request that all referrals are done through the e-referral platform.
