Audiology
NHS Tayside RefGuide
Who to refer
Adults
Uncomplicated hearing loss should be directed to self-refer. See below under ‘Who not to Refer’.
Adult with complex hearing loss or co-morbidities such as dual sensory impairment, poor dexterity, cognition issues (please note many of these patients will be redirected through the self-referral service with copies of the issues stated in a report on clinical portal)
tinnitus or hyperacusis - GP to refer - no self-referral on offer. Cases where a referral is needed:
If there are additional red flags such as unilateral tinnitus
If the patient has symptoms of hyperacusis with their tinnitus
If the tinnitus is troublesome
If the tinnitus is affecting their sleep
Any patient with Benign Paroxysmal Positional Vertigo.
Patients with any other Vertigo symptoms should be referred to ENT for triage and may be redirected to Audiology by the ENT Clinician.
Children
Any child who has given their family or involved professional reason to suspect that they may have an ongoing hearing problem.
All children with a significant speech and language delay.
All children with significant developmental delay or disability.
Who not to refer
All patients who present with routine adult hearing loss can now self-refer to Audiology. Information and the self referral forms can be accessed here, on NHST website and are available through all Audiology locations, GP surgeries, Hearing Aid Volunteer Clinic locations and CTAC centres. There is no requirement for GP to see patient prior to self-referral.
If any of the following history and examination findings are evident at the time of referral, the patient should be referred directly to the Ear, Nose and Throat (ENT) department or other local specialist pathways, and not to Audiology:
History
Sudden loss or sudden deterioration of hearing (sudden = within 72 hours), unilateral or bilateral, should be sent to A&E or Urgent Care ENT clinic within 24 hours. Due to the variety of causes of sudden hearing loss, the treatment timescale should be decided locally by the medical team. Prompt treatment may increase the likelihood of recovery.
Altered sensation or numbness in the face or observed facial droop.
Persistent pain affecting either ear, which is intrusive and which has not resolved as a result of prescribed treatment. (As a general guideline, this includes pain in or around the ear, lasting a week or more in recent months).
History of discharge (other than wax) from either ear within the last 90 days, which has not resolved or responded to prescribed treatment, or which is recurrent.
Rapid loss or rapid deterioration of hearing (rapid = 90 days or less).
Fluctuating hearing loss, other than associated with colds.
Tinnitus, which is persistent and which:
is pulsatile.
has significantly changed in nature.
Adults with other types of tinnitus may be directly referred to Audiology, where they can be assessed and referred on if appropriate.
Vertigo other than that associated with BPPV.
Ear examination
Complete or partial obstruction of the external auditory canal preventing full examination of the eardrum. If any wax is obscuring the view of the eardrum, the GP surgery (or referrer) should arrange wax removal prior to making a referral to Audiology.
Abnormal appearance of the outer ear and/or the eardrum examples include inflammation of the external auditory canal, perforated eardrum, active discharge, eardrum retraction, abnormal bony or skin growths, swelling of the outer ear or blood in the ear canal.
Other findings
Any other unusual presenting features at the discretion or the referrer.
How to refer
GP referrals via SCI Gateway/Audiology
Self-Referrals: Post to Audiology, NHS Tayside, Kings Cross Health & Community Centre, Clepington Road, Dundee, DD3 8EA or E-mail form to TAY.audiology@nhs.scot
Specialty Description
The Audiology Service in NHS Tayside provides assessments to establish the extent, site and cause of hearing and balance impairments alongside experienced staff providing rehabilitation, practical support and ongoing assistance to individuals with hearing loss, balance difficulties or associated problems such as tinnitus and hyperacusis. We assess and treat patients of all ages from Newborn Hearing Screening upwards.
We have 2 separate but interlinked services, one for Paediatrics and One for Adults. The service is based in Kings Cross Health & Community Care Centre in Dundee, Outpatients at Perth Royal Infirmary, The Regional Treatment Centre in Stracathro, with clinics also held at Pitlochry Community Hospital, Crieff Community Hospital and Whitehills Health and Community Care Centre in Forfar.
General information about our service is available on the NHS Tayside Audiology Service webpages.
The Audiology team in NHS Tayside are also the first team in Scotland to be UKAS accredited for the Improving Quality in Physiological Services (IQIPS) programme across all of their services in Dundee, Perth & Stracathro.