NHS HighlandTransforming Audiology Services

Karen WilliamsonAlison Robertson

Bill McKerrowSimonie Craig

Maimie Thompson

ENT Net Demand - All Referral Sources Nov 07 to Dec 08

472

399

439

453460

470

488

444

463

371

469

361

405

364

300

350

400

450

500

550

600

Nov-07

Dec-07

Jan-08

Feb-08

Mar-08

Apr-08 May-08

Jun-08

Jul-08 Aug-08

Sep-08

Oct-08

Nov-08

Dec-08

Net Demand - Option 1 Mean

432

ENT Review of Referrals (Raigmore)

• 10-20% referrals could be managed in a different way … NOW– Quality of referral information– GPs to start and complete treatment before deciding

to refer– Referrals could be avoided- if process for GPs to

access advice– Following pathways (eg Direct to Audiology)

• Nurse Led Developments (Returns)• Change in Pathway – Audiology > 18

Pilot of Actions Taken

• Nurse- Led Daily Vetting of ENT Referrals• GP review of Referrals• Draft Pathway for Audiology Screening• Pilot of Hand-Held Audiology Screener• Joint Nurse/Audiologist BAHA Clinic• Nurse –Led Ear Care Clinic

• New Pathway for Direct to Audiology

Direct Access to Audiology

• Widening direct access from >55 to 18 Years +– 3 Month Secondment (Senior Audiologist)– Revise Referral Form & Process– New Pathway to include Screening test & Questionnaire– Management of Returns– Work closely with ENT– Simple Evaluation

• Was referral appropriate ? • How many were referred onto ENT• Is ear drum visible• Does intervention reduce demand into ENT?• Feed-back from patients

Spanners, Red Herrings & Lime Light