Background and rationale
Telephone clinics in otorhinolaryngology have become increasingly common
in response to
the novel coronavirus 19 disease (COVID19) pandemic; driven by a need to
reduce footfall within the hospital environment, optimise clinic
capacity and manage increasing waiting times1. Indeed,
there is evidence to suggest that many routine otorhinolaryngology
referrals can be managed over the telephone without a face-to-face
assessment2. The pandemic has put considerable strain
on the National Health Service (NHS), as evidenced by the impact on
planned service delivery, where there are now six million patients on
the waiting list, compared to 4.4 million prior to the
pandemic4. As part of the ongoing pandemic recovery,
it is vital that patients are triaged and reviewed promptly and
therefore telemedicine in some form is likely to remain part of practice
in otorhinolaryngology. This is compounded by ongoing uncertainties
surrounding COVID19, such as the emergence of new variants.
Additionally, the potential for staff absences and self-isolation may
necessitate flexible working, whereby remote clinics can be conducted
from an off-site location, rather than deferring care. Whilst telephone
consultations can be effective, a visual inspection of the ear, via
either an otoscope or a rigid endoscope, alongside a pure-tone audiogram
and tympanogram is usually an essential component of routine outpatient
assessment for most otology patients. This is likely of higher priority
in the assessment of new referrals, who have not been examined
previously, compared to follow-up appointments. To date, there is
nothing in the published literature looking at the utilisation of
telephone consultations for the management of new otology referrals and
whether outcomes are comparable to more traditional face-to-face
assessments. This data is important to further our understanding of
telephone consultations in otology, to better inform service design and
to optimise patient care.