Palpable Neck Lump and Bump Referral

Direct access to ultrasound (US) in experienced hands offers rapid assessment of an undiagnosed neck lump.  This pathway will also offer access to ultrasound guided fine needle aspiration (USG FNA) at the same appointment, if required.

Our gold standard service for palpable neck masses will offer instant access to US and USG FNA assessment in addition to a booked core biopsy service in appropriate patients, with further imaging requested and arranged if required to aid diagnosis. Alternative investigations may also be recommended.

The aim;

·         Improve patient experience by offering timely investigations

·         Reassurance for benign pathologies or absence of significant findings

·         Avoid delays in diagnosis

The vast majority of neck lumps are benign. By utilising the pathway, the GP will be provided with communication about what to do next to support and treat the patient either within primary care or through a routine referral to the hospital for further specialist consultation.  For those cases where something suspicious is seen, the pathway offers a continuous flow of care within the trust providing assurance of a timely diagnosis and treatment plan for both the patient and the referring clinician.

In essence, it is about ensuring that each stage of the pathway happens quickly, that communications with patients are effective and that the entire team works in a coordinated but flexible way, focusing always on the patient’s journey and experience.

·         What if the patient I am referring does not meet the criteria on the referral form?

Please consider alternative route of referral or seeking advice and guidance. The referral will be triaged at the point of receipt and if the specialist head and neck sonographer/Consultant Sonographer feels the patient is not suitable for the pathway this will be communicated to the GP and advice given.

·         How will the patient appointment be arranged for the ultrasound  clinic assessment?

The administrative teams within radiology will contact the patient directly to book a suitable appointment.

·         How will the referring clinician be advised of any diagnostic outcomes and next steps required?

All reports and actions will be sent to the GP so that they are informed of any findings and what actions/ support is required by the referring clinician. This will be in the already familiar form of a radiology report.

·         If the suspicion of cancer is raised how will this be communicated with the referring clinician?

All diagnostic reports will be sent directly back to the referring clinician and at the point of confirmed diagnosis this will be communicated with the GP by letter.

·         If the suspicion of cancer is raised how will this be communicated with the patient?

As the patient moves through the pathway the reasoning for the diagnostics will be discussed and explained. A confirmed diagnosis will be communicated via a Head and Neck Consultant with the support of a Clinical Nurse Specialist.