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\begin{document}

\title{Telephone Clinic Outcomes during the COVID-19 pandemic in an Ear, Nose
and Throat Department}



\author[1]{Sohaib Mallick}%
\author[2]{Ramkishan Balakumar}%
\author[1]{Andrew Drysdale}%
\affil[1]{Taunton and Somerset NHS Foundation Trust}%
\affil[2]{Sheffield Teaching Hospitals NHS Trust}%


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  \date{May 27, 2024}


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\begin{abstract}
Background \& Aim The COVID-19 pandemic led to interesting challenges,
when delivering outpatient care during the national lockdown. This was
especially pertinent in Otolaryngology, which is not only very heavily
outpatient based but also very highly procedural focused. It also
presented difficulties for patients shielding due to being deemed high
risk. Following advice given by both the NHS and ENT UK, all routine
clinics were cancelled and telephone consultations introduced to
maintain an ENT service for patients. This study looks at the impact of
telephone clinics in a district general hospital on patient outcomes and
what benefits can be gained from this method of service delivery. Study
Design A retrospective study was undertaken examining telephone clinic
consultations of newly referred patients over seven days during a
nationwide lockdown. This included all adult and paediatric patients
referred routinely. Follow-up patients and 2 week wait referrals were
excluded. Higher risk patients were identified using guidelines listed
by the NHS and the hospital electronic patient database was used to
collect patient information. Clinic outcomes were collected and collated
on Microsoft Excel. Patients were followed up to 8 months. Results Data
was collected from 104 patients. The age ranged from 1 to 91; with 74
patients being seen by consultants, 18 by registrars and 12 by associate
specialists. Outcomes of these consultations showed that 17 patients
were discharged, 15 had outpatient imaging requested, 11 referred to
another specialty, 11 had further telephone clinic follow up, 31 were
given patient initiated follow up and 19 were brought back for
face-to-face appointments. Overall, 57\% of patients avoided a hospital
visit and only 17\% needed a face-to-face appointment. Of the patients
who were higher risk, 49\% were managed remotely. After 8 months there
was no significant morbidity or mortality. Conclusions Almost half of
all higher risk patients avoided coming in to hospital. The majority of
patients were managed remotely and thus reduced the risk and spread of
infection to patients and staff. This shows that telemedicine has been a
significantly useful mode of service delivery during the pandemic and
has further scope in routine ENT outpatient care.%
\end{abstract}%



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