DIRECT LISTING FOR ADULT TONSILLECTOMY

Health care economic efficiency is important. Adult tonsillectomy is a common operation. The decision to operate is made at an out-patient c onsultation and is based on information in the general practitioner's (GP) referral letter. This study aims to define what proportion of adu lt tonsillectomies are suitable for listing with an out-patient consul tation (direct listing). GPs were informed of the indications (six epi sodes of tonsillitis in the last pear) and contraindications (tonsille ctomy for another reason and general ill health) for direct listing. A ll referrals for 1 year were screened by an otolaryngologist and suita ble patients were listed directly. Patients were then reviewed in the anaesthetic pre-admission clinic and inappropriate listings were cance lled and reasons noted. Of all patients, 50% were suitable for direct listing. Of these 3% were later deemed inappropriate. None of the canc ellations were due to a flaw in the direct listing process. This would result in savings to the NHS of pound 1.2 million per annum.