Head & Neck Clinic

1. Explore: choose a presentation and expand one answer at a time. Changing an answer removes its later findings.
2. Apply: use a patient simulation to practise interpretation, urgency and decisions.
3. Reflect: review feedback and linked guidance, then revisit the relevant tree branch.

“Two-week-rule” is the familiar clinic label. Timing and local referral pathways do not replace clinical judgement; see the explanation and guidance within the consultation.

This is a fictional learning prompt, not a patient questionnaire or triage tool. Do not enter or store real patient information.

Registrar: prepare the referral question

• Summarise the presenting concern and distinguish reported symptoms from confirmed findings.
• Identify what is known, what is missing, and which source or local pathway version you would check.
• State your provisional next step, why it fits the available facts, what would change it, and who will own follow-up of each requested result.
• Explain uncertainty, safety-netting and when you would seek senior review; do not delay urgent escalation while completing a routine work-up.

Consultant or supervisor: discuss the reasoning

• Check whether the referral question, urgency, available evidence and applicable local pathway have been represented accurately.
• Explore reasonable alternatives, competing risks, patient priorities, investigation trade-offs and explicit responsibility for communication and follow-up.
• Give specific feedback on the rationale and handover, then agree what needs verification or escalation. This prompt does not grade competence.

Educational discussion only: clinicians remain responsible for decisions under current guidance, local policy and the patient’s circumstances.

Use this fictional structure to discuss a handover; it is not a referral form, mandated dataset or substitute for the current local pathway. Do not enter patient information.

1. Question: what symptom or finding prompted review, and what remains unconfirmed?
2. Priority and rationale: what is the intended route, why is it appropriate to the facts, and what current national/local source was checked?
3. Request: what specific assessment or action is being asked of the receiving service, within the locally agreed process?
4. Uncertainty: what competing explanation, missing fact or limitation could change the plan?
5. Ownership: who will arrange the next step, track each result, explain it and act if it is delayed or discordant?
6. Patient communication: what has been explained about next contact, unresolved concerns, deterioration and how to re-contact the responsible service?

Confirm receipt and responsibility using local policy. This learning scaffold neither sets urgency criteria nor grades clinical performance.