Thyroid nodules are common, but the incidence of thyroid cancer occurring within them is very low. Nonetheless, patients presenting with thyroid lumps are frequently worried that they have cancer, and the wait for a diagnosis to be confirmed or refuted is highly stressful. This presents challenges to the clinician, in determining who requires extensive investigations, and how best to reassure patients in whom this is not indicated. However, satisfied patients are more likely to cooperate with treatment, continue the relationship with their treating physicians and enjoy a better outcome. A dedicated weekly thyroid lump clinic was launched in 2010 held jointly between endocrinology, ENT and radiology. The aim of this clinic was to reduce unnecessary investigations, improve patients experience and to improve outcomes, by enabling all necessary procedures to be conducted in a one stop clinic. Patients are asked by letter to have their blood tests taken before attending their appointment. The letter also explains what to expect on their visit to the clinic, warns patients that their visit may be prolonged, and gives contact details of the endocrine specialist nurse who will be their key worker. All patients were invited to complete an anonymous ten-point questionnaire following their clinic visit and asked to hand them into reception or return by post. The survey was stopped after fifty completed questionnaires were returned. 98% respondents understood the purpose of their appointment. 100% were satisfied with the communication and one-stop nature of the service. 72% of patients knew their key worker before the appointment and similar number understood that they might have additional tests on the day. By streamlining care and adopting an MDT approach, we believe that we have improved patient experience, improved the standard of care and improved communication in a cost neutral service redesign.
Declaration of interest: There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.
Funding: No specific grant from any funding agency in the public, commercial or not-for-profit sector.