Two Audits of the Diagnosis of Oral Cancer and the Two-Week Rule following Referrals from Primary Care Practitioners in Newcastle

Abstract

Aim The aim of the two audits was to evaluate the success of the two-week rule in the oral and maxillofacial surgery (OMFS) department at the Newcastle General Hospital (NGH) and then subsequently in the oral surgery and oral medicine departments at Newcastle Dental Hospital (NDH). Methods All two-week referrals seen at the NGH over a one-year period were examined retrospectively. An identical subsequent audit was carried out at the NDH over a second one-year period, also retrospectively. Results In the initial audit at the NGH, a total of 63 two-week referrals were received during the one-year period analysed. Of these, 57 (90%) were seen within the appropriate time period, and 60 (95%) conformed to the Department of Health guidelines. Seven (11%) of the 63 referred patients were diagnosed with head and neck cancer, indicating a positive oncology detection rate of 11%. In the later audit at the NDH, 49 urgent referrals were assessed. Forty-three of the 49 referrals (88%) were seen within the appropriate time period and thirty-nine (80%) were compliant with the referring guidelines. Forty-five patients attended for assessment and the resultant positive oncology detection rate for these patients was 7%. In both audits, the patients diagnosed as having positive oncology results all had referrals that were compliant with the Department of Health guidelines. Conclusions Both of these audits indicated that the national guidelines for two-week referrals were usually appropriately followed in the two departments that were audited. However, in the future, further education of referring practitioners should ensure that these guidelines are followed better, making the service provided more efficient for all concerned.