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.