GP referral

Same day

• Has symptoms and signs of a more serious illness or condition
• Has a persistent high fever (>38°C)
• Has significant difficulty in swallowing (dysphagia)
• Has a high risk of complications – immunosuppressed or on treatment for cancer
• Is taking carbimazole, methotrexate or azathioprine.

Less urgent referral

• Not systemically unwell but condition not covered by PGD or not meeting PGD criteria
• Masses/unilateral swellings (possible cancer)
• Persistent mouth ulcer/lesions (possible cancer)
• Recurrent problem, or treated within last month
• Has had the sore throat for longer than seven days and it is not getting better
• Persistent, ‘low grade’ sore throat for over three weeks, may be unilateral (possible cancer)
• Has had recurrent bouts of throat infection/tonsillitis
• Has hoarseness that has lasted longer than three weeks.