Maxillofacial Unit Referral Guidelines

The maxillofacial unit (MFU) manages disease of the mouth, face, neck and jaws in adults and children.

 Guidelines

Standards and Targets
Patients with suspected head and neck malignancy will be seen within 14 days of the date of referral.
All patients will be seen within 13 weeks of the date of referral.

These guidelines have been written in conjunction with the Bradford Local Dental Committee in order to assist the Maxillofacial Unit (MFU) to meet the above standards and targets. It will only be possible to meet and maintain these standards and targets if patients are referred appropriately. Inappropriate referrals are wasteful of limited hospital resources and delay the diagnosis and treatment of urgent cases. This document is intended to assist general practitioners in referring patients to the MFU for diagnosis and/or treatment. While this document is advisory and not proscriptive if practitioners wish to refer a patient whose condition(s) falls outside these guidelines they should fully justify their reasons for doing so. Referrals that do not comply with these guidelines may be returned to the referring practitioner for further details and/or clarification.
The MFU consultants are always willing to discuss individual cases or problems with practitioners personally or by telephone.

• The practitioner should clearly state the reason for referral and what s/he is requesting the MFU to do for his/her patient stating the level of urgency
• An urgent referral should be reserved for conditions like genuine suspected malignancy, acute facial trauma, severe infections and/or swellings and severe pain
• The MFU appreciate practitioner's difficulties but inappropriate urgent referrals delay the timely treatment for patients in genuine need of urgent treatment
• Urgent referrals for suspected malignancy should be made using the specific Bradford or Airedale Hospitals 14-day wait proforma
• All relevant details concerning the patients' dental and medical history and current complaint should be recorded in order to assist the MFU in appropriately prioritising the degree of urgency
• The trusts and MFU will audit the appropriateness of these referrals
• Patients should be referred to a named consultant (Mr Worrall, Mr Sutton, Mr Patel or Mr McCaan) at the referring practitioners' discretion.
• If no consultant preference is indicated patients will be assigned to the consultant with the shortest waiting list
• Whenever possible referrals should be typed or word processed to aid legibility and avoid confusion
• Referrals should be signed personally by the referring practitioner and not by his or her deputy
• Referrals for extraction of wisdom teeth should comply with the N.I.C.E. third molar guidelines

The following categories of patients should not be routinely referred to the MFU for treatment

• Non-medically compromised children or adults requiring routine dental treatment
• A patient's inability or unwillingness to obtain and/or pay for dental treatment is not an indication for referral to the MFU
• Dental phobic patients and those with special needs that prevent them accessing general dental services should be referred to the community dental service if they can not be treated in general practice
• Non-medically compromised children or adults requiring simple (non-surgical) dental extractions
• The majority of such extractions should be performed in general practice or the community dental service as appropriate