title: Quality improvement in action. Direct general practitioner referrals to audiology for the provision of hearing aids: a single centre review.
abstract: Direct referral audiology clinics (DRACs) for the assessment and provision of hearing aids in those over 60 years of age were initially introduced in the National Health Service (NHS) as a method to decrease outpatient waiting times and reduce demand on ear, nose and throat (ENT) appointments. We retrospectively reviewed the electronic records of 353 patients referred to the DRACs at our hospital over a four-month period to determine the continued benefits of a DRAC service, in terms of impact upon ENT appointments, and appropriate general practitioner (GP) use of the clinics. Of the 353 patients seen within the DRAC clinics, 320 were ultimately provided with a hearing aid. Fifty five patients required review by an otolaryngologist, either being referred directly by the audiology department or referred back to their GP for re-referral. The greatest lack of adherence to the referral criteria for DRAC appointments related to appropriate treatment of wax within the community, with two patients declining an aid when their perceived improvement in hearing was significant following microsuctioning. DRACs appear to continue to provide a cost-benefit to the NHS, reducing demand on ENT appointments, but further improvements could be made within primary care to further utilise this service.
authors.affiliation: Norfolk and Norwich University Hospital NHS Trust, Norwich, UK.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Eley
authors.forename: John E
authors.initials: JE
authors.lastname: Fitzgerald
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002571:Cerumen; D003362:Cost-Benefit Analysis; D005194:Family Practice; D005260:Female; D006310:Hearing Aids; D034381:Hearing Loss / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology; D012017:Referral and Consultation / Q000191:economics*; D012189:Retrospective Studies; D006113:United Kingdom