Referral Management Service (RMS) Triage Guidance – Humber and North Yorkshire
The LDC has been made aware that there has been some concern regarding the criteria used by RMS triagers when assessing referrals in Humber and North Yorkshire.
The following information has been provided by the RMS and their Clinical Audit Lead to clarify the approach used when triaging referrals.
Triage Principles
The triager’s role is to identify the complexity of the case and then consider any relevant medical or clinical factors that may influence the appropriate referral pathway.
National Guidance
The primary document used as the basis for oral surgery triage nationally is:
National Oral Surgery Commissioning Guidelines
https://www.england.nhs.uk/long-read/oral-surgery-clinical-standard/
Additional Clinical Guidance
Where clinically relevant, triagers may also refer to other national guidance documents relating to oral surgery and associated medical considerations. These may include guidance covering:
Medication-related osteonecrosis of the jaw (MRONJ)
https://www.sdcep.org.uk/published-guidance/medication-related-osteonecrosis-of-the-jaw/Conscious sedation
https://www.sdcep.org.uk/media/iota3oqm/sdcep-conscious-sedation-guidance-unchanged-2022.pdfMRONJ guidance (updated version)
https://www.sdcep.org.uk/media/xtlp2uqx/sdcep-mronj-guidance-extant-2024.pdfManagement of patients taking anticoagulants or antiplatelet drugs
https://www.sdcep.org.uk/media/ypnl2cpz/sdcep-management-of-dental-patients-taking-anticoagulants-or-antiplatelet-drugs-2nd-edition.pdfNICE guidance relating to third molar management
https://www.nice.org.uk/guidance/cg64Antibiotic prophylaxis guidance
https://www.sdcep.org.uk/media/qvpj2kfb/sdcep-antibiotic-prophylaxis-implementation-advice.pdfSelection criteria for dental radiography
https://cgdent.uk/wp-content/uploads/securepdfs/FGDP-SCDR-ALL-Web.pdfRoyal College of Surgeons guidance for surgical endodontics
https://www.rcseng.ac.uk/-/media/files/rcs/fds/publications/surgical_endodontics_2012.pdfNICE guidance relating to wisdom tooth removal
https://www.nice.org.uk/guidance/ta1/chapter/10-Wisdom-teeth-removal-patient-notes
Local Input
If there are specific clinical considerations or local requirements that clinicians feel should be taken into account for patients being treated within Humber and North Yorkshire, these can be proposed for inclusion to support triagers operating within the region.
Practitioners are encouraged to contact the LDC if they wish to suggest additional relevant guidance or clarification.