British Tinnitus Association

The Tinnitus Pathway in the Audiology section of the NHS programme, Do Once and Share (DOaS) was completed in November 2006 and has been published on the NHS website. The scheme provides General Practitioners and others with the correct referral pathway for patients. The Tinnitus Pathway team was led by BTA Professional Adviser, David Baguley and included a number of other members of the BTA Professional Advisers Committee, Petter Tungland, Don McFerran, Laurence McKenna and Lucy Handscomb. The pathway refers, in several places, to obtaining patient information from the BTA.

Below is an article written by Christine Gregson of the Edinburgh and South East Scotland Tinnitus Group. It describes the early days of the ‘Do once and share’ patient pathways, of which the tinnitus pathway is one of the first to be completed. It was previously published as an article in Quiet.

The Edinburgh and S. E. Scotland Tinnitus Group is one of only two groups active in Scotland. In June 2004 we were invited to supply a representative for an initiative by the Scottish Executive Health Department. This initiative aimed to develop decision support tools (Patient Pathways) that would help busy G.P.s direct patients effectively. Our Patient Pathway was aimed at Ear Nose and Throat, but that would include those with tinnitus, classed as a "hearing problem".

Working with senior audiologists and consultants seemed like a daunting prospect, but the opportunity was too good to pass up. The Group nominated me - as their Secretary - to attend and feed in what information I received from our members. I am pleased to say that any misgivings were unwarranted. The professional medics were attentive and willing, both to help and indeed to learn from the lay participants. It was clear that feedback from patient representatives was wanted and that we could influence these directions for G.P.s. I felt that there was real collaboration between health professionals, patient representatives and the Scottish Health Department.

Through attending the meetings, held in venues across Scotland, I learnt a great deal about ear problems in general and hearing problems in particular. I did some peripheral reading to stay abreast of the terminology, which itself was fascinating and educational.

The completed "Patient Pathways" were always intended to help G.P.s decide which of several possible routes the patient might take, depending on symptoms or diagnostic evidence. These Pathways were not presented as mandatory: they were offered to NHS Boards as a national resource for local adaptation and implementation.

I have gathered that the take up rate by NHS Boards in Scotland has been encouraging, with different regions implementing them in different ways. Locally for instance, NHS Lothian adopted a number of Pathways and placed them on their intranet site for G.P. guidance. Early feedback suggests that users of the Pathways considered them to be a good educational tool and useful for streamlining the patient journey.

There were two instances where I felt we were particularly useful. At one meeting I took along the BTA's own information sheet aimed at G.P.s. This greatly impressed the medical specialists present (not G.P.s). They decided the reference to this information should be included in the Pathway, including BTA's contact details

The second instance was as a result of my unease at trying to answer the many questions put to me (by 'phone) by those newly diagnosed. I wanted to be absolutely sure that what I was saying was accepted by the medical profession. I asked for their help and although it was outwith their remit their help was promptly offered. What followed was collaboration between the BTA's medical experts and those on the Scottish panel to produce a list of the most frequently asked questions and recommended answers. This piece of information was endorsed by the BTA and we now distribute it to new members with the BTA logo sitting proudly on top.

I felt that the exercise was worthwhile, that the medical staff I met were willing to listen and to help. I feel that speakers, whether consultant ear surgeon or audiologist that have spoken to our Group since then have been aware of the Pathways and able to explain to us that there is method and logic in what can seem a haphazard journey through medical appointments.

The leaflet below, about DoAS, is produced by, and copyright of, MRC Manchester and NHS Connecting for Health.  We still have a few copies available from the office for those who do not wish to, or cannot, download it.