TY - JOUR
T1 - Tinnitus referral pathways within the national health service in England
T2 - A survey of their perceived effectiveness among audiology staff
AU - Gander, Phillip E.
AU - Hoare, Derek J.
AU - Collins, Luke
AU - Smith, Sandra
AU - Hall, Deborah A.
N1 - Funding Information:
The following clinicians are thanked for their contributions to the development of this research, Veronica Kennedy (NHS Bolton), Amr El Refaie (Bristol University), Usame Karim (Walsall Hospitals NHS Trust), Jaika Witana (Sheffield Teaching Hospitals NHS Foundation Trust), Tim Husband (The Mid Yorkshire NHS Trust), Sara Coulson (Barnsley Hospital NHS Foundation Trust), Richard Nicholson, Julie Carr, Charlotte Rogers, James Slinger, Edward Thompson, Daljit Methon, John Birchall and Thomasina Meehan (Nottingham University Hospitals NHS Trust). Thanks also to the British Tinnitus Association and the Royal National Institute for Deaf People for sharing database information, and to Huw Cooper (University Hospitals Birmingham NHS Foundation Trust) and Michelle Booth (Sherwood Forest Hospitals NHS Foundation Trust) for information on the direct-access tinnitus pilot projects. The National Biomedical Research Unit in Hearing (NBRUH) is funded by the National Institute for Health Research (NIHR).
PY - 2011/7/6
Y1 - 2011/7/6
N2 - Background: In the UK, audiology services deliver the majority of tinnitus patient care, but not all patients experience the same level of service. In 2009, the Department of Health released a Good Practice Guide to inform commissioners about key aspects of a quality tinnitus service in order to promote equity of tinnitus patient care in UK primary care, audiology, and in specialist multi-disciplinary centres. The purpose of the present research was to evaluate utilisation and opinions on pathways for the referral of tinnitus patients to and from English Audiology Departments.Methods: We surveyed all audiology staff engaged in providing tinnitus services across England. A 36-item questionnaire was mailed to 351 clinicians in all 163 National Health Service (NHS) Trusts identified as having a tinnitus service. 138 clinicians responded. The results presented here describe experiences and opinions of the current patient pathways to and from the audiology tinnitus service.Results: The most common referral pathway was from general practice to a hospital-based Ear, Nose & Throat department and from there to a hospital-based audiology department (64%). Respondents considered the NHS tinnitus referral process to be generally effective (67%), but expressed needs for improving GP referral and patients' access to services. 'Open access' to the audiology clinic was rarely an option for patients (9%), nor was the opportunity to access specialist counselling provided by clinical psychology (35%). To decrease the number of inappropriate referrals, 40% of respondents called for greater awareness by referrers about the audiology tinnitus service.Conclusions: Respondents in the present survey were generally satisfied with the tinnitus referral system. However, they highlighted some potential targets for service improvement including 1] faster and more appropriate referral from GPs, to be achieved through education on tinnitus referral criteria, 2] improved access to psychological services through audiologist training, and 3] ongoing support from tinnitus support groups, national charities, or open access to the tinnitus clinic for existing patients.
AB - Background: In the UK, audiology services deliver the majority of tinnitus patient care, but not all patients experience the same level of service. In 2009, the Department of Health released a Good Practice Guide to inform commissioners about key aspects of a quality tinnitus service in order to promote equity of tinnitus patient care in UK primary care, audiology, and in specialist multi-disciplinary centres. The purpose of the present research was to evaluate utilisation and opinions on pathways for the referral of tinnitus patients to and from English Audiology Departments.Methods: We surveyed all audiology staff engaged in providing tinnitus services across England. A 36-item questionnaire was mailed to 351 clinicians in all 163 National Health Service (NHS) Trusts identified as having a tinnitus service. 138 clinicians responded. The results presented here describe experiences and opinions of the current patient pathways to and from the audiology tinnitus service.Results: The most common referral pathway was from general practice to a hospital-based Ear, Nose & Throat department and from there to a hospital-based audiology department (64%). Respondents considered the NHS tinnitus referral process to be generally effective (67%), but expressed needs for improving GP referral and patients' access to services. 'Open access' to the audiology clinic was rarely an option for patients (9%), nor was the opportunity to access specialist counselling provided by clinical psychology (35%). To decrease the number of inappropriate referrals, 40% of respondents called for greater awareness by referrers about the audiology tinnitus service.Conclusions: Respondents in the present survey were generally satisfied with the tinnitus referral system. However, they highlighted some potential targets for service improvement including 1] faster and more appropriate referral from GPs, to be achieved through education on tinnitus referral criteria, 2] improved access to psychological services through audiologist training, and 3] ongoing support from tinnitus support groups, national charities, or open access to the tinnitus clinic for existing patients.
UR - http://www.scopus.com/inward/record.url?scp=79959890607&partnerID=8YFLogxK
U2 - 10.1186/1472-6963-11-162
DO - 10.1186/1472-6963-11-162
M3 - Review article
C2 - 21733188
AN - SCOPUS:79959890607
SN - 1472-6963
VL - 11
JO - BMC Health Services Research
JF - BMC Health Services Research
M1 - 162
ER -
