Reviewed on : 9 Jul 2021

Reviewed by : Gateway Editor

Expires : 9 Jul 2023

Adult Hearing Service (AQP) Update April 2021

Coventry and Warwickshire CCGs have recently completed a successful tender for AQP Audiology Adult Hearing increasing the providers of this service from April 2021 onwards.

The new providers that will be delivering the service covering Coventry and Warwickshire with On-site testing based in shops and delivering domiciliary service are:

• Industrial Diagnostics
• Mediscan Diagnostic Services*
• Scrivens Limited
• South Warwickshire NHS Foundation Trust – site in the South Warwickshire only
• Specsavers

Domiciliary service only covering all areas:

• Complete Price Eyewear t/a The Outside Clinic

*Please be advised MEDISCAN DIAGNOSTIC SERVICES, one of the adult hearing service providers that cover all four places of our CCG, has had to suspend services for a period of time as per CQC inspections in June and concerns in their processes have been raised. As a result they will not be providing Audiology clinics from 23rd June 2021 until 25th August 2021 or until CQC guidance.

This provider has been temporarily removed from the booking system. The CCG is working with the provider to identify if any patients are currently booked in that will need to be changed to a different provider to complete their adult hearing service. 

The Adult Hearing Service (AQP) is aimed at:

• Patients registered with a Coventry and Rugby Place GP aged 19 or over

• Patients registered with a South Warwickshire Place GP aged 55 and over

• Patients registered with a Warwickshire North Place GP aged 50 and over

Assessment

Consider likely cause: hereditary, blocked canal, infection, perforation, otitis media with effusion (glue ear), old age, otosclerosis, noise-induced, viral, trauma, toxins (such as gentamicin, NSAIDs, chemotherapy), acoustic neuroma, Menieres, vascular, auto-immune, non-organic.

Management

• Clear wax – very thoroughly if hearing aid required
• Treat infection
• Simple otitis media with effusion (OME) – wait 2-3 months then refer if not resolved.

Signposting Guide for GPs

Refer patient to NHS Hearing Service (AQP) UNLESS YES is answered to history of any of the following then refer to Secondary Care Services:

• Persistent pain affecting either ear (defined as earache lasting more than 7 days in the past 90 days before appointment)
• Unilateral Hearing loss
• History of discharge other than wax from either ear within the last 90 days
• Sudden loss or sudden deterioration of hearing (sudden=within 1 week) which case send to A&E or Urgent Care ENT clinic)
• Rapid loss or rapid deterioration of hearing (rapid=90 days or less)
• Fluctuating hearing loss, other than associated with colds
• Unilateral or asymmetrical, or pulsatile or distressing tinnitus lasting more than 5 minutes at a time
• Troublesome tinnitus which may lead to sleep disturbance or be associated with symptoms of anxiety or depression (see also AUDIOLOGY COMPLEX DIRECT REFERRAL)
• Abnormal auditory perceptions (dysacuses)
• Vertigo
• Normal peripheral hearing but with abnormal difficulty hearing in noisy backgrounds; possibly having problems with sound localization, or difficulty following complex auditory directions.
• Complete or partial obstruction of the external auditory canal preventing proper examination of the eardrum and/or proper taking of an aural impression.
• Abnormal appearance of the outer ear and/or the eardrum (e.g.,inflammation of the external auditory canal, perforated eardrum; active discharge).
• Before referring for a hearing aid, please ensure ear wax is very thoroughly cleared, to allow effective testing and fitting.

Referral

Sudden onset of severe, unilateral hearing loss – contact ENT on call at UHCW.

Children under 16 years usually go to the Paediatric Audiology Clinic at Child and Family Services, 4th floor, City of Coventry Health Centre, 2 Stoney Stanton Road, CV1 4FS. Tel Paediatric Audiology admin 02476961092

Referrals should be marked “for Paediatric Audiology”.

Consider referring to hospital ENT if pain, perforation, etc. See link for Grommets & Myringotomy in Children

Between 16-18 years of age – Refer to UHCW

Referral to Adult Hearing Service (AQP)

Referrals to this service may differ according to place:

Coventry & Rugby Place GP patients:

• Self-Referral and GP Referral

South Warwickshire Place GP patients and Warwickshire North Place GP patients:

GP Referral only

E-referral

All providers will be available on e-referral to offer patients choice.

New patients are to be seen within 21 calendar days to ensure they are assessed and treated if applicable for hearing.

Wax Removal

As part of the pathway the following service is in place for wax removal:

Coventry & Rugby Place GP patients

• Wax removal is provided by the audiology provider only to support the fitting of hearing aids

South Warwickshire Place GP patients and Warwickshire North Place GP patients

• Patients should they require wax removal will be referred back to the GP to access the local commissioned services

Any queries regarding the service changes please contact samantha.thorne6@nhs.net

• Tinnitus, Hearing Loss, Hearing or Listening Difficulties

• Click for link to Audiology Complex Direct Referral – (Audiology Triage Service)

Domiciliary provider for housebound patients only

The Outside Clinic operates a mobile domiciliary care service at the place of patients permanent resident.

Tel: 0800 954 9101 to arrange an appointment or refer via the NHS e-Referral Service.

See below for guidance on e-Referral

Hearing aid batteries

It will be the responsibility of the patient to fund replacement aids in the event of loss or damage unless the patient has a diagnosis of dementia, learning disabilities or blindness confirmed by the referring GP, in which case the cost of £50 will be borne by the Commissioner.

Unfortunately this criteria has to be applied uniformly across all sites, Specsavers replacement price is slightly higher as we renewed their contract recently, if the aid is over three years old then could go to Specsavers and self-refer for a new aid, if not then the replacement price will have to be paid.

Patients can collect hearing aid batteries from UHCW Out-patients Department, Clinic 8. Alternatively they can telephone the Trust on 024 7696 6444 and the batteries will be posted.