Ear, nose and throat

Audiology

If you are over 55 and are having problems with your hearing, your GP can refer you to one of our audiology providers for an assessment.

These providers are:

• Alistair Kinsey Ltd (Tavistock)
• Northern Devon Healthcare NHS Trust
• Royal Cornwall Hospitals NHS Trust
• Scrivens Ltd
• Specsavers
• The Outside clinics (for those who need an assessment at home)
• University Hospitals Plymouth NHS Trust

If you are under 55 and experiencing problems with your hearing, your GP will be able to refer you to an appropriate service. Normally the ENT or audiology departments at one of the hospitals.

Aural care

This service is run by specialist nurses. They help the ENT consultants by treating conditions such as

• cholesteatoma
• discharging ears
• mastoid cavities
• otitis externa
• perforation of ear drums
• surfers ear for treatment of otitis externa
• wax impaction where the commissioning policy criteria is met

Read our commissioning policy (PDF, 1.5MB).

Aural care briefing

NHS Kernow commissions Royal Cornwall Hospitals NHS Trust (RCHT) to provide an aural care service for ENT. This nurse led service is not only designed to see people needing complex ear wax removal via microsuction but supports our ENT consultants by seeing people with ear conditions such as active infection and disease that erodes bone which could progress and cause significant complications such as infection in and around the brain, dizziness and permanent irreversible hearing loss if not managed regularly.

To ensure that we utilise this resource appropriately, there is a longstanding agreement in place that certain criteria (PDF, 1.5MB) must be met for referrals to be accepted in to the service.

Some people may only need to attend 1 appointment for microsuction but others may have a number of appointments over a longer period of time. A clinical assessment on when a person can be discharged is applied to all patients based on criteria set by the ENT department. Whilst an average appointment time slot for aural care is about 15 minutes per patient, there are currently around 2,000 awaiting a follow-up appointment within the aural care department.

Some patients have been contacted recently to advise that they no longer need to be seen by the aural care team. This is because the department is currently reviewing their waiting list or follow-up lists and applying discharge criteria. Such reviews are essential in light of the recent events of COVID-19 which means that social distancing measures reduce the number of appointments available in clinic and therefore the amount of people that can be treated. NHS Kernow is fully supportive of RCHT conducting these clinically led reviews and applying the access and discharge criteria that has been previously agreed.

NHS Kernow and RCHT would like to reassure them that every person who has been discharged has had a clinical evaluation of their medical records against the clinical criteria for discharge. Each individual has been given detailed advice on self- management of their condition from home without the need to attend for a further hospital appointment.

NHS Kernow confirms that this is not a withdrawal of a service nor is it based upon any financial cut backs. It is however paramount if we are going to have enough resource across Cornwall and the Isles of Scilly in treating those with the most pressing clinical need. If a patient’s condition changes and they subsequently meet the access criteria for the service, they can be re-referred by their GP.

ENT

ENT services are delivered by our hospital providers, including Royal Cornwall Hospitals NHS Trust and University Hospitals Plymouth NHS Trust. Access to these services is via a referral from your GP where you’ll be seen by a consultant or a member of their team.

Conditions treated include:

• chronic cough
• fractured noses
• head and neck cancer
• neck lumps
• paediatric sleep apnoea
• persistent ear pain
• rhinitis/sinusitis
• throat problems
• unilateral tinnitus