Thank you for offering the opportunity to comment on audiology services—my comments are those of an experienced Head of Service.

  1.  The published data of high audiology waiting lists expressed in the media is that of a worst case scenario, mainly reflecting areas that have particular recruitment and retention issues and/or budgetary pressures. My own service has no waiting list either for diagnostic or rehabilitative audiology and has held this position for in excess of eighteen months. All patients referred into this department are contacted and offered appointments within days, and we have not, and do not, expect to have any problems meeting the 18 week diagnostic target. The majority of my colleagues in and around Greater Manchester also report minimal audiology waits—exception Stockport Acute Trust.

  2.  Waiting times in audiology are influenced by the historic requirements of the local ENT services and their target waiting list pressures. These audiology waits can be affected by changing audiology practice and allowing GP's to directly refer into the audiology departments for all ages and all hearing problems. This change in working and referring patterns having both positive benefits for the patient and practitioner, not to mention waiting lists. Audiologists, as a group, are keen to embrace change as proven by the modernisation of hearing aid services some seven years ago, and the majority would adopt changes in referral patterns and role in a very positive mode.

  3.  The NHS has the capacity to treat high numbers of audiology waits providing that commissioners look further than their local PCT boundaries, and by talking directly to the Audiology experts locally. By employing and utilising surplus capacity/good will in adjacent areas the NHS could manage the majority of these waits without any Independent Sector procurement.

  4.  Changes in workforce profiles, the results of Agenda for Change and the financial position that many Trusts find themselves in, suggests that the current employment of newly qualified audiologists is reaching saturation point. Resources should reflect the skill mix required by changing practice-skills for health and any new investments should also be in delivering training at the Associate Practitioner level.

  5.  As already stated, as a service without a waiting list, the role of the independent sector is currently redundant in this area, North Manchester. However for patient choice the employment of dually qualified audiologists and true partnership working (NHS and registered with the Hearing Aid Council) can only compliment an excellent service and offer income to stretched NHS budgets.

Mrs Jan Harling

Head of Audiology, North Manchester General Hospital

18 January 2007