Improving Laryngeal Procedure Workflow: Moving From the Operating Room to the Outpatient Setting

Laryngology disease burden is growing while theater capacity is falling. Over half a million patients are waiting for ENT care in England alone (1). The demand for laryngology services has continued to grow significantly, particularly post-COVID (2). Meanwhile, the number and efficiency of ENT theater lists are reduced (3). To tackle the growing backlog, NHS England has emphasized the need for innovative strategies by separating elective from emergency services and by increasing the resilience of elective delivery (4). The establishment of an office-based laryngology procedure clinic is a potential solution.

We offer a narrative review and audit of our experience in founding an in-office laryngology procedure service within a tertiary NHS center with the aim of streamlining this setup process for other interested ENT units.

We outline an in-depth exploration of the personnel, equipment, and processes necessary to establish an in-office procedure clinic. Our experience showed that the procedure clinic functions well when implemented within the framework of existing ENT elective and emergency services. Although there is initial investment required in terms of money, effort, and time, our outcomes show that the clinical and economic benefits of the clinic outweigh the costs, also allowing for patients to access investigations and treatments reliably and efficiently.

Setting up a laryngology in-office procedure clinic within the NHS confers patient, organizational, and economic benefits. It provides a novel and resilient approach in addressing the growing backlog of patients awaiting laryngology care and should be popularized in the current health care environment.

4 Laryngoscope, 135:1132-1142, 2025.