NHS Highland
Transforming Audiology Services
Karen Williamson
Alison Robertson
Bill McKerrow
Simonie Craig
Maimie Thompson
ENT Net Demand - All Referral Sources
Nov 07 to Dec 08
600
550
500
488
472
470
453
450
469
463
460
444
439
432
405
399
400
371
364
361
350
300
Nov07
Dec07
Jan08
Feb08
Mar- Apr-08 May08
08
Jun- Jul-08 Aug08
08
Net Demand - Option 1
Mean
Sep08
Oct08
Nov08
Dec08
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
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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 +
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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
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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