The following comments are based on experience and observations of Audiologists and in no way necessarily reflect the views of Kings College Hospital NHS Foundation Trust.

Whether accurate waiting times for audiology services are available?

  1.  Accurate information is available at some departments. It is likely that the format in which it is held may differ from place to place.

Why audiology services appear to lag behind other specialties in respect of waiting times and access and how this can be addressed?

  2.  Increased waiting times at this hospital have resulted from:

—    increased number of new referrals;

—    the need to see all new referrals within 13 weeks as the expense of other appointments;

—    reduced staffing levels over several years and particularly with the withdrawal at end March 2006 of additional DoH funding as part of the MHAS project; and

—    the need for longer appointment slots to fit and follow up DSP hearing aids compared with analogue aids, hence reducing throughput.

  3.  The difficulties could be addressed by:

—    funding audiology services as a separate discipline rather than as part of ENT;

—    investing in adequate staffing establishment to cope with the workload;

—    ensuring that test and auditory rehabilitation facilities meet minimum standards; and

—    invest in adequate equipment to cope with workload.

Whether the NHS has the capacity to treat the numbers of patients waiting?

  4.  The NHS does not currently have the capacity to treat all the patients; this is not only lack of staffing establishment, but also inadequate facilities, varying between departments.

Whether enough new audiologists are being trained?

  5.  There are qualified Audiologists, both recently trained in the UK and foreign trained, who are unable find employment. This is not because there is not work available, but because there are inadequate posts for the workload.

How great a role the private sector should play in providing audiology services?

—    It is likely that farming out work to private sector as proposed, and as is happening already in some areas, will be more expensive than properly funding existing Audiology departments.

—    Provision of services via mobile units is unsatisfactory as patients are very unlikely to have immediate access for follow up or if they experience problems, unlike services provided by the NHS where an appointment can be offered on request.

—    If patients are unable to obtain an immediate appointment via the private sector they are likely to visit their local NHS department. Audiologists will be unable to help them as they have already been seen by an alternative so called "service provider". Only after a further GP referral to the NHS will a patient be seen in their local clinic when the Audiologists will be obliged to duplicate work, obviating the need for the original referral to the private sector.

—    There is a danger of missed diagnoses if patients are assessed in the private sector; they may have other Audiological or ENT problems which will not be identified.

—    For private sector involvement to be successful it is imperative that all patient data is passed to the local NHS department, but it seems that the costs significantly outweigh the benefits.

Dinah Taylor

Audiologist, Kings College Hospital NHS Foundation Trust

 [comments made as an individual]

8 February 2007