GPwSI / GPwER ENT

• Undertake specialist ENT clinics for patients referred from primary care.
• Assess, diagnose, and manage a wide range of ENT conditions within the community setting.
• Perform appropriate procedures within your scope of practice.
• Provide expert clinical advice and support to GP colleagues and multidisciplinary teams.
• Contribute to the development and continuous improvement of ENT pathways and services.
• Work collaboratively with secondary care ENT specialists to ensure seamless patient care.
• Support education and knowledge-sharing across the wider primary care workforce.

• Adults and paediatric patients within the locally commissioned age range presenting with routine, stable ENT conditions suitable for community-based assessment and management.
• Patients requiring Tier 2 ENT assessment where appropriate primary-care treatment has failed, diagnostic uncertainty remains, symptoms persist, or specialist ENT assessment and clinical decision-making is required.
• Common uncomplicated ear conditions, including recurrent or chronic otitis externa, cerumen impaction requiring microsuction, Eustachian tube dysfunction, glue ear within the agreed adult scope, and simple dry tympanic membrane perforation.
• Non-sudden hearing loss requiring clinical assessment, basic audiology, reassurance, advice or onward referral to an appropriate hearing-aid pathway.
• Non-pulsatile tinnitus without neurological, unilateral or other red-flag features.
• Peripheral vertigo or dizziness consistent with a benign cause and suitable for management or onward referral through an agreed community vestibular pathway, where commissioned.
• Chronic rhinitis, uncomplicated chronic rhinosinusitis, nasal obstruction, uncomplicated nasal polyps and deviated nasal septum requiring community ENT assessment.
• Recurrent minor or non-complex epistaxis suitable for outpatient assessment and simple nasal cautery.
• Globus, throat discomfort, recurrent tonsillitis, benign tonsillar disease and low-risk dysphonia/hoarseness following appropriate triage and suitable for community ENT assessment.
• Benign-appearing ear or nasal lesions suitable for diagnosis, reassurance or an agreed minor-procedure pathway.
• Patients requiring diagnostic procedures available within the commissioned service, which may include otoscopy/otomicroscopy, basic audiology, tympanometry, nasendoscopy, microsuction and simple nasal cautery.
• Patients suitable for management within a community ENT setting where there is no requirement for emergency intervention, complex imaging, general anaesthesia, inpatient care or tertiary ENT assessment.

• Suspected head and neck cancer or other urgent suspected-cancer presentations, including neck lumps, persistent unexplained unilateral symptoms, unexplained weight loss, haemoptysis, significant dysphagia/odynophagia or persistent hoarseness meeting urgent referral criteria.
• Acute or emergency presentations, including airway compromise, stridor, severe dysphagia, significant haemorrhage or uncontrolled epistaxis, mastoiditis, severe infection, sepsis or other conditions requiring emergency assessment.
• Sudden sensorineural hearing loss, acute facial nerve palsy, neurological deficit, central vertigo or other acute neurological or neuro-otological presentations requiring urgent specialist assessment.
• Pulsatile tinnitus or concerning unilateral tinnitus requiring urgent investigation or specialist imaging.
• Non-healing oral ulcers or lesions requiring dental, oral and maxillofacial or suspected-cancer assessment, including primary dental conditions.
• Acute nasal fracture or significant facial trauma.
• Suspected obstructive sleep apnoea unless an agreed community sleep pathway forms part of the commissioned service.
• Complex airway, voice or swallowing disorders, aspiration risk or conditions requiring specialist speech and language therapy, hospital-based MDT assessment or tertiary input.
• Patients with an obvious requirement for surgery, general anaesthesia, inpatient or overnight care, complex imaging or specialist tertiary ENT management.
• Cochlear implant assessment, skull-base disease, complex otology and other tertiary ENT subspecialty conditions.
• Procedures or treatments falling outside the agreed GPwSI / GPwER ENT scope, commissioned service, facility, equipment or available clinical workforce.
• Patients outside the locally commissioned age or geographical criteria, referrals that cannot be safely triaged because of incomplete clinical information, or treatment requiring unapproved individual funding.

Essential

• Full GMC registration with a licence to practise.
• Inclusion on the GP Register.
• Evidence of specialist training, accreditation, or substantial experience in ENT.
• Experience managing patients with common ENT presentations.
• Excellent clinical assessment, diagnostic, and decision-making skills.
• Strong communication and multidisciplinary working abilities.
• Commitment to delivering high-quality, patient-centred care.

Desirable

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