New Plan to Improve Ear, Nose and Throat Services

New community-based audiology services capable of managing direct referrals from primary care for hearing loss, tinnitus and dizziness are to be set up in Wales, freeing up hospital-based services to treat the most complex cases, Welsh Labour’s Deputy Health Minister Vaughan Gething has announced.

The move is part of a new plan from the Welsh Labour Government to transform ear, nose and throat (ENT) services in the Welsh NHS. The National ENT Implementation Plan aims to improve patient experience and outcomes, whilst developing a sustainable service, building on a series of developments to provide effective and efficient planned care for implementation by health boards across Wales.

The plan requires health boards to understand and measure demand, capacity and activity in ENT and establish a patient experience measure for ENT services in Wales.

As part of the plan, new measures will be put in place to ensure only the right patients are managed in doctor-led secondary care, with the vast majority of patients seen in community-based services. Health boards will establish community-based audiology services capable of managing direct referrals from primary care for hearing loss, tinnitus and vertigo/dizziness.

Other measures include:

  • Health boards will ensure NICE “do not do” and “interventions not normally undertaken” are no longer undertaken. For example, a tonsillectomy will only  be performed if a patient meets a certain threshold, that is, at least six episodes of tonsillitis during a 1 year period;
  • Health boards will undertake a waiting list “validation” to remove patients who don’t require either outpatient appointments or surgery, which will help reduce waiting times for patients who need urgent treatment;
  • Follow-up appointments should only be given where absolutely necessary, freeing up doctors’ time to treat more patients;
  • Where a follow up outpatients appointment is required, this will increasingly be a “virtual” appointment, for cases when it is safe and appropriate to give advice using different means of communication;
  • All patients will have a smoking and weight assessment as part of their referral pathway for a routine ENT outpatient appointment. Smokers and those patients with a BMI>35 will be referred to the appropriate local service for anti-smoking and weight reduction management respectively as part of their active treatment;
  • Collaborative care groups (between hospital, community and primary care) will be established to empower patients to manage their own health.

ENT is one of the key specialist services in the NHS in Wales encompassing a high volume of children’s surgery, cancer treatment as well as a range of adult services including patients with significant hearing disability. There were over 84,000 new ENT outpatient referrals in Wales last year and approximately 15,000 treatments were undertaken.

The plan can be found here.

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