James Paget Hospital smell clinic 'victim of own success'

Referrals to the JPUH Smell and Taste Clinic have been put on hold until March 2013

A pioneering NHS unit helping people living without a sense of smell has been told by hospital bosses its referral lists must close after becoming a "victim of its own success".

Referrals to the Smell and Taste Clinic at the James Paget University Hospital (JPUH), near Great Yarmouth, Norfolk, have increased from just a couple a month to nearly 100, following recent media coverage.

Hospital management, now concerned the acceptance of more referrals will have a detrimental effect on patient waiting times, have stopped the unit accepting new patients until at least March 2013.

Patients not seen within 18 weeks from referral-to-treatment (RTT) incur a financial penalty for the JPUH under the NHS Standard Contract.

The hospital has also been warned by health watchdog Monitor it must meet RTT waiting time targets by January 2013 or face action.

John Studley, JPUH medical director, said: "Unfortunately the clinic has been something of a victim of its own success.

'Frustrating' decision

"Due to the high volume of referrals resulting from recent publicity in the BBC and national press, the clinic is not accepting new patients in order that we can deal with the patients already referred."

The clinic is the only one of its kind in the UK.

Anosmia, an inability to smell, affects an estimated three million people in the UK and can be present from birth. It can also be caused by chronic sinusitis, head trauma from an accident or the common cold.

Mr Philpott operates on about 100 patients a year

Consultant surgeon Carl Philpott, who runs the clinic, said the decision was "frustrating", but appreciated the JPUH had to be "realistic" about what could be managed on "finite resources".

He said it was an area of medicine in the UK where knowledge was lacking and was missing a proper "referral pathway".

"From the outpouring of people with anosmia we've had over the last couple of months it's very frustrating not to be able to see those patients and give them an opportunity for assessment - ultimately you want to be there to help the patients," said Mr Philpott.

"It's very upsetting but we have to be positive and look forward to a way we can manage this problem in the wider scale in the future."

The JPUH's Mr Studley said: "The NHS Constitution gives patients the legal right to access services within maximum waiting time targets.

Seeking 'reassurance'

"We are required to treat non-urgent patients within 18 weeks. Mr Philpott's list has been closed temporarily, so that we can treat the outstanding patients.

"We are advising patients and their GPs who refer to the Smell and Taste service that we hope to reopen the list to new referrals in March next year.

"The kind of expertise Mr Philpott has is, unfortunately, not readily available, so it's not a case of us simply being able to expand our capacity to meet the demand. We do apologise for the inconvenience."

Research has shown that 50% of patients living with anosmia also have to deal with depression. Many also live with a major loss of taste as about 80% of taste comes from a sense of smell.

Duncan Boak, founder of the UK's first anosmia support group Fifth Sense, said: "I understand it from the hospital's point of view - all of sudden they've had all these referrals and they are clearly not in a position to deal with them.

"I want to see reassurance from the JPUH they are taking this seriously and talking to the Department of Health with a view to pressing them for the necessary funding to support the ground-breaking work Mr Philpott is doing.

"But the problem is with the NHS as a whole taking the sense of smell and its loss a lot more seriously than they have done.

"The sheer number of referrals demonstrates a clear need for an appropriately funded centre for anosmia and related rhinological problems."

The JPUH clinic has been running for about 19 months and has treated more than 100 patients from around the UK.