Page 33 - Primary Care Audiology

Integration with ENT

“For conditions beyond the scope of audiology services, referrals can
be made directly to ENT departments from the audiology service. The
development of these non-surgical pathways will be one of the most
significant and effective transformations in ENT outpatient practice.”
NHS, Transforming ENT Outpatient Services
70

As with any speciality, not all care can or should be delivered
in primary care settings. Examples include complex surgical
specialities and medical conditions that require centralised
infrastructure and skills, which should remain hospital based.
In these cases, the goal is to help patients access the hospital care
they need in the most efficient way. In ear and hearing care, this can
be achieved with better integration of primary care audiology and
ENT, ensuring people are referred appropriately and do not suffer
undue delays in accessing the support and treatment they need.

In a related example, primary care optometrists test and correct
vision and other issues, referring between only 3% and 5% of
patients to hospital when clinically necessary. Likewise, hospital
departments can treat and discharge patients back to primary eye
care or continue to co-manage patient needs outside hospital. 71
It makes sense to replicate this model between primary care
audiology and ENT, especially as the prevalence and incidence of ear
disease in the adult population is typically lower than eye disease. In
doing so, we estimate that primary care audiology could manage 95%
of adult patients closer to home without referral to secondary care. 72

“About 40% of new referrals [to ENT are for] uncomplicated
hearing problems and simple perennial rhinitis, and others include
wax, presbyacusis, tinnitus and a runny nose.”
ENT UK 73

Primary care audiology – accessible ear and hearing care for all 33