For GPs
Appointments
Appointments and referrals can be made by you or your GP via The Electronic Referral Service (e-RS) or CAS, or by ‘Yellow Boards’ direct from the wards.
Waiting times
The average waiting time for the maxillo-facial outpatient clinics is:
- for cancer cases up to 2 weeks
- for routine appointments: up to 2½ months.
For Dentists
london referral form (Word doc)
NHS London Oral Surgery referral form (PDF)
Referral Criteria Update
The Homerton Maxillofacial Surgery Department is committed to providing specialist oral surgery services to patients requiring complex care. However, we have noted an increase in inappropriate Tier 1 referrals for simple extractions that should be managed in primary care.
As per NHS England guidance and your GDS contract/PDS Agreement, NHS providers and performers are expected to carry out extractions of teeth and retained roots that fall within their competence. The patient should ONLY be referred if they present with special difficulties that lie outside the competence of a GDP.
What We Do Not Accept (Tier 1 Procedures):
- extractions of fully erupted teeth with favourable root formation
- simple retained roots that are accessible
- routine extractions in medically fit patients (ASA I-II)
- third molars that are fully erupted and not in close proximity to the inferior dental canal
What We Do Accept:
- failed extractions with documented attempt (please send post-extraction radiograph)
- patients with severe dental anxiety requiring sedation/GA (with completed anxiety assessment)
- teeth with abnormal root morphology (demonstrated radiographically)
- impacted teeth requiring bone removal and surgical division
- teeth with significant cystic changes requiring histological analysis
- extractions with high risk of damage to anatomical structures
- patients with severe medical complications as outlined in guidelines13
All referrals must include high-quality radiographs showing the entire tooth. Failure to include these may result in rejection and delay in patient care.
If you feel unable to perform a procedure that is within the scope of general practice, please consider:
- seeking support from colleagues within your practice
- attending continuing professional development courses to improve skills
- contacting our department by telephone for advice before referring
Please consider referral to IMOS/ Community dental services for the following:
- failed extractions with documented attempt (please send post-extraction radiograph)
- ASA1/2 patients with severe dental anxiety requiring sedation (with completed anxiety assessment)
- teeth with abnormal root morphology (demonstrated radiographically)
We are implementing a comprehensive vetting process to ensure appropriate use of our specialist services and to maintain timely access for patients requiring complex care or cancer pathway treatment. Inappropriate referrals will be rejected and returned to the referring practitioner.
For further information on improving extraction skills, Health Education England provides regular hands-on courses for dentists.
Thank you for your understanding and cooperation in improving the oral surgery care pathway.
Cancer Referral
Visit the Healthy London.org website for more information on cancer referrals.