All referrals from GPs should be made via the e-Referrals Service here: e-RS
Referral Quick View Summary
Referrals from GPs
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Urgent Suspected Cancer
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- complete the current version of Head & Neck Pan-London Urgent Suspected Cancer form, attach any supporting documents, including clinical photos, if available
- select 2WW Head & Neck RAS on e-RS * and submit
- clinical specialist will review and book appointment
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Routine
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select routine oral and maxillofacial on e-RS *
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Referrals from Dentists
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Urgent Suspected Cancer
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Routine
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- please note, we do not accept referrals for periodontal disease, endodontics, restorative and prosthodontic treatments.
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Waiting times
The average waiting time for the maxillo-facial outpatient clinics is:
- for cancer cases up to 2 weeks
- for routine appointments is up to 18 weeks.
Urgent Suspected Cancer Referral Guidance
All urgent suspected head and neck cancer referrals are triaged by a clinical nurse specialist. For referral forms, criteria, and general guidance, see NHS England — London » Urgent Cancer Referrals . Further information on the referral process is available for GPs and other healthcare professionals here: Homerton Urgent Cancer referrals. This includes referral pathways, procedures, preparations, our appointment letters and patient information leaflets.
Please ensure your referrals meet the NG12 guidelines, as detailed in the Pan-London urgent suspected cancer form. If we do not think a referral meets the criteria, we will ask the referrer to either give more details or withdraw the referral.
To help us quickly rule out cancer in benign lesions and prioritise urgent cases, we deliver a One Stop Oral Biopsy clinic. We strongly encourage you to attach clinical photos of lesions with your referral documents. Please inform your patients to be prepared for possible same day biopsy under local anaesthetic.
GPs should refer head and neck lumps to the Urgent Suspected Cancer pathway. These cases will be managed by Oral Maxillofacial Head and Neck surgical team.
Dentists who spot a suspicious neck lump on a patient can refer directly to our urgent suspected cancer pathway. You do not need to refer the patient back to their GP for them to refer to us.
If any clinician refers a patient for a suspicious neck lump, please inform them they may receive an appointment for ultrasound scan with fine needle aspiration (FNA) within a few days of the referral.
Routine Referral Guidance
The Homerton Maxillofacial Surgery Department is committed to providing specialist oral surgery services to patients requiring complex care. We do not cover periodontal disease, endodontics, restorative and prosthodontic treatments.
Our routine outpatient services include:
- Head & Neck Lump Clinic
- Maxillo Facial, Head & Neck Surgery
- Oral & Denteolveolar Service.
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, the General Dental Services (GDS) contract and Personal Dental Services (PDS), expects primary care dentists to carry out extractions of teeth and retained roots that fall within their area of competence. The patient should ONLY be referred if they present with special difficulties that lie outside the competence of a general dental practitioner.
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
We Do Accept:
- surgical Orthodontic dental extractions including expose and bond procedures. Referrals must include original treatment plan with letter from the orthodontist.
- 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 from dentists 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)
For further information on improving extraction skills, Health Education England provides regular hands-on courses for dentists.
Inappropriate referrals to our routine clinics will be rejected and returned to the referring practitioner. Thank you for your understanding and cooperation in improving the oral surgery care pathway.
