{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:06:40Z","timestamp":1789654000747,"version":"4.0.0"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Head and neck cancer (HNC) referral conversion in the UK is less than 3%. A nurse\u2010led telephone assessment clinic (TAC) using the HaNC\u2010RC v.2 triage tool was introduced to identify high\u2010risk (HR) referrals.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Prospective data were collected from all HNC referrals (\n n<\/jats:italic>\n \u2009=\u2009986) over 6\u2009months, with descriptive analysis of TAC triage outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Over 6 months, 986 referrals were reviewed, with a 4.4% (\n n<\/jats:italic>\n \u2009=\u200943) cancer conversion rate. Of 483 (49.0%) TAC patients, 115 (23.8%) were high\u2010risk (HR) triaged using the HaNC\u2010RC v.2 tool. Cancer was diagnosed in 8 (7.0%) HR and 3 (0.9%) LR patients (early thyroid malignancies), who were subsequently upgraded to HR (\n p<\/jats:italic>\n \u2010value\u2009=\u2009<\u20090.001) with FDS compliance of 88% (95% CI: 83.5\u201392.1). Allowing for clinical capacity constraints, the first F2F clinical appointment with an HNC consultant was given to 63.1% of HR patients, and 7.7% of these patients were later confirmed to have cancer. HR and LR patients were seen within a mean of 9.2 and 10.2\u2009days (\n p<\/jats:italic>\n \u2010value\u2009=\u20090.043), respectively. The mean waiting time was improved from 10.7\u2009days (1st month) to 5.9\u2009days (6th month) for an HR clinic slot (\n p<\/jats:italic>\n \u2010value\u2009=\u20090.04).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This service evaluation study supports the use of the HaNC\u2010RC v.2 at the 7.1% threshold in a TAC nurse\u2010led clinic model alongside an STT pathway. The TAC service facilitated optimised use of consultant clinic slots, prioritising HR patients without compromising LR patients' outcomes and facilitated a reduction in USoC clinic slot requirements whilst helping FDS target compliance.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/coa.70164","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T13:56:17Z","timestamp":1789653377000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nurse\u2010Led Telephone Triage Clinic Service for Head and Neck Suspected cancer Referrals: A Prospective Study of 986 Referrals"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0898-8425","authenticated-orcid":false,"given":"Raiza Elmira S.","family":"Imperial","sequence":"first","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery St. George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6030-9407","authenticated-orcid":false,"given":"Charlotte","family":"Freeman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery St. George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Lyons","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery St. George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arunjit","family":"Takhar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery St. George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Oikonomou","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery St. George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babatunde","family":"Odutoye","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery St. George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enyinnaya","family":"Ofo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery St. George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2828-2874","authenticated-orcid":false,"given":"Theofano","family":"Tikka","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Head and Neck Surgery St. George's University Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"NHS England \u201cImplementing a Timed Head and Neck Cancer Diagnostic Pathway: Guidance for Local Health and Care Systems \u201dLondon: NHS England 2024 Publication approval reference: PAR1130 https:\/\/www.england.nhs.uk\/publication\/rapid\u2010cancer\u2010diagnostic\u2010and\u2010assessment\u2010pathways\/."},{"key":"e_1_2_11_3_1","unstructured":"Cancer Research UK \u201cHead and Neck Cancers: Statistics by Cancer Type \u201dLondon: Cancer Research UK 2021 accessed June 11 2025 https:\/\/www.cancerresearchuk.org\/health\u2010professional\/cancer\u2010statistics\/statistics\u2010by\u2010cancer\u2010type\/head\u2010and\u2010neck\u2010cancers."},{"key":"e_1_2_11_4_1","unstructured":"NHS Digital \u201cCancer Waiting Times Urgent Suspected Cancer Referrals: Referral Conversion and Detection Rates \u201dNational Disease Registration Service (NDRS) \u2013 NHS England 2025 accessed 21 August 2025 https:\/\/nhsd\u2010ndrs.shinyapps.io\/cwt_referral_conversion_detection\/."},{"key":"e_1_2_11_5_1","unstructured":"NHS England \u201cNational Cancer Waiting Times Monitoring Dataset Guidance: Faster Diagnosis Standard Specifics \u201dLondon: NHS England n.d. accessed 11 June 2026 https:\/\/www.england.nhs.uk\/long\u2010read\/national\u2010cancer\u2010waiting\u2010times\u2010monitoring\u2010dataset\u2010guidance\/#2\u2010faster\u2010diagnosis\u2010standard\u2010specifics."},{"issue":"3","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1111\/coa.13511","article-title":"Head and Neck Cancer Risk Calculator (HaNC\u2010RC)\u2010V.2: Adjustments and Addition of Symptoms and Social History Factors","volume":"45","author":"Tikka T.","year":"2020","journal-title":"Clinical Otolaryngology"},{"issue":"22","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"4177","DOI":"10.1002\/cncr.33800","article-title":"Remote Triage Incorporating Symptom\u2010Based Risk Stratification for Suspected Head and Neck Cancer Referrals: A Prospective Population\u2010Based Study","volume":"127","author":"Hardman J. C.","year":"2021","journal-title":"Cancer"},{"issue":"1","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1007\/s12070-023-04412-x","article-title":"Implementation of the Symptom\u2010Based Risk Calculator for Head and Neck Cancer HaNC\u2010RC v.2 Post COVID\u201019 Pandemic: A Single\u2010Centre Audit","volume":"76","author":"Hatoum A.","year":"2024","journal-title":"Indian Journal of Otolaryngology and Head & Neck Surgery"},{"issue":"3","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1007\/s00405-021-07135-3","article-title":"Remote Triaging of Urgent Suspected Head and Neck Cancer Referrals: Our Experience During the First Wave of the COVID\u201019 Pandemic","volume":"279","author":"Kaddour H.","year":"2022","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"issue":"6","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1017\/S002221512400015X","article-title":"A Novel Remote Assessment Pathway to Streamline the Management of Two\u2010Week\u2010Wait Suspected Head and Neck Cancer Referrals: A Prospective Analysis of 660 Patients","volume":"138","author":"Metcalfe C.","year":"2024","journal-title":"Journal of Laryngology and Otology"},{"issue":"4","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"2519","DOI":"10.1007\/s00405-026-10023-3","article-title":"A Nurse\u2010Led Telephone Clinic Can Safey Triage Suspected Head and Neck Cancer Referrals Using the Head and Neck Risk Calculator","volume":"283","author":"North A. S.","year":"2026","journal-title":"European Archives of Oto\u2010Rhino\u2010Laryngology"},{"key":"e_1_2_11_12_1","unstructured":"National Institute for Health and Care Excellence (NICE) \u201cSuspected Cancer: Recognition and Referral (NICE Guideline NG12) \u201dLondon: NICE 2015 accessed 21 August 2025 https:\/\/www.nice.org.uk\/guidance\/ng12\/chapter\/Recommendations\u2010organised\u2010by\u2010site\u2010of\u2010cancer#head\u2010and\u2010neck\u2010cancers."},{"key":"e_1_2_11_13_1","unstructured":"Health Research Authority \u201cIs My Study Research?\u201dLondon: HRA and Medical Research Council 2022 accessed August 17 2025 https:\/\/www.hra\u2010decisiontools.org.uk\/research\/."},{"issue":"7","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1017\/S0022215121003157","article-title":"Telephone Consultation for Two\u2010Week\u2010Wait ENT and Head and Neck Cancer Referrals: Initial Evaluation Including Patient Satisfaction","volume":"136","author":"Rovira A.","year":"2022","journal-title":"Journal of Laryngology and Otology"},{"issue":"8","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1017\/S0022215120001267","article-title":"North East London Coronavirus Disease 2019 Protocol for Diagnostics in Two\u2010Week Wait Head and Neck Cancer Patients","volume":"134","author":"Warner E.","year":"2020","journal-title":"Journal of Laryngology and Otology"},{"issue":"4","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1111\/coa.14057","article-title":"Head and Neck Cancer: A 6\u2010Year Retrospective Analysis and Review of Three Common Triaging Systems","volume":"48","author":"Siddiqui Z.","year":"2023","journal-title":"Clinical Otolaryngology"},{"issue":"3","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.bjoms.2011.05.002","article-title":"Analysis of the Impact of Deprivation on Urgent Suspected Head and Neck Cancer Referrals in the Mersey Region Between January 2004 to December 2006","volume":"50","author":"Brocklehurst P.","year":"2012","journal-title":"British Journal of Oral & Maxillofacial Surgery"},{"key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1111\/coa.14269","article-title":"Risk Stratification of Suspected Head and Neck Cancer Referral Letters: A Prospective Cohort Study","volume":"50","author":"Hill A.","year":"2025","journal-title":"Clinical Otolaryngology"},{"issue":"14","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"656","DOI":"10.12968\/bjon.2023.0289","article-title":"Setting Up a Nurse\u2010Led 2\u2010Week\u2010Wait Head and Neck Cancer Diagnostic Service","volume":"33","author":"Byrne E.","year":"2024","journal-title":"British Journal of Nursing"},{"issue":"9","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"e3","DOI":"10.1016\/j.bjoms.2020.06.020","article-title":"Skills and Competences Needed by Nurses to Allow Them to Deliver a Safe Nurse\u2010Led Oral and Maxillofacial Oncology Clinic: The Leeds Experience","volume":"58","author":"Ong H.","year":"2020","journal-title":"British Journal of Oral & Maxillofacial Surgery"},{"issue":"1","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.bjoms.2019.08.030","article-title":"Our Experience of a Nurse\u2010Led Oral and Maxillofacial Surgical Clinic in a Tertiary Centre: Two Years on","volume":"58","author":"Spellman J.","year":"2020","journal-title":"British Journal of Oral & Maxillofacial Surgery"},{"issue":"4","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.bjoms.2018.01.020","article-title":"Early Experience of a Nurse\u2010Led Clinic in a Tertiary Centre","volume":"56","author":"Spellman J.","year":"2018","journal-title":"British Journal of Oral & Maxillofacial Surgery"},{"issue":"2","key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.bjoms.2020.08.089","article-title":"Nurse\u2010Led Oral and Maxillofacial Oncology Clinics: A Review","volume":"59","author":"Kyzas P.","year":"2021","journal-title":"British Journal of Oral & Maxillofacial Surgery"},{"issue":"1","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1111\/coa.14232","article-title":"Socioeconomic Inequality in the Head and Neck Cancer Referral System: Redressing the Balance","volume":"50","author":"Tengku S.","year":"2025","journal-title":"Clinical Otolaryngology"},{"issue":"1","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1111\/coa.14226","article-title":"Artificial Intelligence Led Telephone Triage of Patients With Suspected Head and Neck Cancer: A Feasibility Study","volume":"50","author":"Mason K.","year":"2025","journal-title":"Clinical Otolaryngology"},{"key":"e_1_2_11_26_1","unstructured":"NHS England \u201cChanges to Cancer Waiting Times Standards From 1 October 2023 \u201dLondon: NHS England 2023 accessed 25 August 2025 https:\/\/www.england.nhs.uk\/long\u2010read\/changes\u2010to\u2010cancer\u2010waiting\u2010times\u2010standards\u2010from\u20101\u2010october\u20102023\/."},{"key":"e_1_2_11_27_1","unstructured":"J.McCrossan \u201cEvidence Brief: Cancer Diagnostics \u201dLondon: Workforce Training and Education Knowledge Management Team NHS England 2025."}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.70164","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/coa.70164","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.70164","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T13:56:24Z","timestamp":1789653384000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.70164"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":26,"alternative-id":["10.1111\/coa.70164"],"URL":"https:\/\/doi.org\/10.1111\/coa.70164","archive":["Portico"],"relation":{},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]},"assertion":[{"value":"2025-12-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"coa.70164"}}