1. Gordon McHardy Head of Audiology Services NHS Grampian Transforming Audiology Services for the Patients of NHSScotland

2. State the Bleedin’obvious Clinical Staff doing clinical Work Maximise use of PMS Standardise rotas – DCAQ Book cancellations Offer alternative locations Waiting list Management Develop staff in other clinical areas

4. Triage Review Patients *= 30 Minute review appointment for Counselling and aid adjustment or exchange as appropriate **= 60 Minute review appointment for Audio/ULL/REM/GHABP/Exchange or adjustment Check Patients address and ascertain where would prefer to be seen. Detailed Journal entries at each patient contact regarding what’s happening and main patient difficulties.

5. Triage Review Patients If Patient requires new moulds at ** appt then ATO can take impressions. Modern Feedback management systems should allow an exchange aid to be fitted even with poor moulds. If wax present ask same questions to ascertain appropriate action/appointment. Phone enquiries – Encourage patients to attend drop-in clinic to have ears/moulds/HA checked.(Record advice given as Journal entry) ? protocol for peripheral clinics

6. Triage Review Patients NHS Grampian approx 1600 Re- assessments/annum Currently 2 appointments total 75 Minutes Propose one stop 60 Minutes Save 400 Hours/annum or 400 additional re-assessments Patient seen more quickly and assessed/treated at “one-stop”

7. One Stop Approx 1800 Direct Referral Patients/annum Currently 2 appointments assessment then return for HA fit (total 2 hours) Proposal GPs use Hearcheck Screener allowing us to appropriately appoint patients into “one- stop” or traditional two appointments

8. One Stop - Benefits Research suggests approx. 1000 patients suitable for one-stop Shorter appt time 90 – 105 minutes Save 250 – 500 hours/annum or 140-280 additional patient journeys Less referrals to Audiology or ENT Shorter waiting times for patients Patients assessed & treated same day

9. One Stop Problems?? Additional test at Primary Care but test time less than 2 minutes and current referral numbers suggest an average of 2- 3 patients/Practice/Month

10. ENT Templates Feast or Famine Approx 2200 New and 1300 Return Audiograms/annum Support on average 16 ENT lists/week over 5 sessions 42 weeks/year to allow for AL etc. Average 5.2 (6) Audiograms per ENT clinic list

11. ENT templates Book Sessions based on 48 weeks/year 5 sessions/week 14.58 (15) Audiograms/session