Consultant ENT

• Providing consultant-led assessment and management of patients referred through central triage or escalated from Tier 2 services.
• Undertaking enhanced outpatient diagnostics, including nasendoscopy, otomicroscopy, audiovestibular testing and imaging review.
• Providing senior clinical decision-making for uncertain diagnoses, persistent symptoms or cases requiring specialist ENT assessment.
• Managing moderately complex chronic ear disease, recurrent otitis, selected dry tympanic membrane perforations, hearing loss and tinnitus where tertiary otology is not required.
• Managing persistent nasal obstruction, chronic rhinosinusitis, uncomplicated nasal polyps and septal deviation, with definitive treatment where appropriate and commissioned.
• Managing persistent globus, benign tonsillar disease and low-risk dysphonia, including laryngeal examination.
• Undertaking biopsy or excision of known benign lesions within the commissioned ambulatory scope.
• Providing selected commissioned low-risk ambulatory/day-case procedures, including septoplasty and turbinate reduction, grommet insertion, selected myringoplasty, day-case tonsillectomy, limited polypectomy, benign lesion removal and selected FESS, subject to appropriate facilities, workforce and anaesthetic governance.
• Working within agreed governance and referral pathways, redirecting patients outside the commissioned scope appropriately.
• Undertaking other duties appropriate to the role as reasonably assigned.

• Nasendoscopy
• Otomicroscopy
• Formal audiovestibular testing
• Review and interpretation of relevant imaging
• Selected low-risk day-case procedures, where specifically commissioned and supported by appropriate facilities, equipment, workforce and anaesthetic governance.

• Tier 2 escalations where diagnostic uncertainty remains, symptoms persist despite adequate treatment, or consultant-level clinical decision-making is required.
• Moderately complex chronic ear disease, including recurrent otitis, selected dry perforations, hearing loss and tinnitus requiring specialist review but not tertiary otology input.
• Persistent nasal obstruction, chronic rhinosinusitis, uncomplicated nasal polyps and septal deviation requiring consultant assessment and consideration of definitive treatment.
• Recurrent epistaxis requiring enhanced specialist assessment and/or an agreed outpatient procedure.
• Persistent globus, benign tonsillar disease and low-risk dysphonia requiring laryngeal examination and consultant-led management.
• Known benign lesions requiring biopsy and/or excision within the commissioned ambulatory procedure scope.
• Selected low-risk ambulatory/day-case procedures, where explicitly commissioned, including:- Septoplasty with or without turbinate reduction
• Grommet insertion
• Selected myringoplasty
• Day-case tonsillectomy
• Limited polypectomy
• Benign lesion removal
• Selected FESS
• Trust waiting-list patients who have already been assessed as suitable for a self-contained ambulatory/day-case pathway, with the required clinical records and diagnostic investigations available.

• Urgent, suspected cancer or red-flag presentations, including patients requiring a head and neck cancer pathway.
• Complex airway, swallowing or voice disorders, significant aspiration risk, or conditions requiring a hospital-based multidisciplinary service.
• Complex dizziness or balance disorders, central neurological signs, or conditions requiring specialist neuro-otology beyond the commissioned service.
• Patients requiring inpatient admission, overnight care, emergency support, complex or multistage surgery, or long-term/lifelong specialist follow-up.
• Tertiary ENT conditions, including cochlear implantation, skull-base disease, complex otology, major head and neck surgery and reconstructive surgery.
• Patients with medical, anaesthetic, safeguarding or functional risks that make the proposed ambulatory/day-case setting inappropriate.
• Procedures falling outside the agreed facility, equipment, workforce or anaesthetic scope, or unresolved diagnostic uncertainty requiring hospital-based MDT review.
• Patients who do not meet the locally agreed age, BMI, ASA, comorbidity or day-case selection criteria.

Essential

• GMC Specialist Registration is essential.
• Completed specialist ENT training, ideally at Consultant level.
• Strong diagnostic and procedural skills across ENT conditions.
• Excellent communication and teamwork abilities.
• DBS clearance required.

Desirable

• Previous experience in outpatient or community ENT services is desirable.