Consultant physicians working with patients - Royal College of ...

2 Specialties Audiovestibular medicineTable 1 Specialised facilities required by an audiological medicine service for a population of 500,000Hearing testingPaediatric• 3 large paediatric soundproof test booths with viewing areas• 1 standard booth with viewing area• 1 child-friendly, hearing aid fitting room• 1 room for taking impressions• 1 room for nurse-led activities, including a microscope and irrigation for aural toileting• 1 acoustically treated, child-friendly, hearing aid prescription room• 1 room for evoked-response audiometry• 1 counselling room for parents• Sufficient rooms for members of the MDT to see and work with children in a child-friendly environment, including consultationrooms for medical examination• 1 waiting room including supervised play facilities for all ages and available refreshmentsAdult• 4 standard audiometric soundproof test booths• 1 evoked-response booth• 2 acoustically treated, hearing aid prescription rooms• 3 hearing aid fitting rooms• 2 comfortable rooms for hearing therapy• 1 room for nurse-led activities, including a microscope and irrigation for aural toileting• 1 large room for group relaxation classes• Sufficient rooms for members of the team to consult and assess patients• 1 waiting roomVestibular testingPaediatric• 1 child-friendly, purpose-designed, vestibular test room with play area and mains water supply• Facilities for comprehensive vestibular testing, including videonystagmography (VNG), electronystagmography (ENG), rotatingchair, posturography and caloric testing (needs mains water supply)• 1 clinical room for physiotherapy and occupational therapyAdult• 1 large vestibular laboratory from which light can be excluded, including VNG, ENG, rotating chair, posturography and calorictesting (needs mains water supply); it needs to be suitable for children and adults• 1 large room for group relaxation and balance retraining• 1 counselling and cognitive therapy roomOverall service• 1 seminar room for MDTs and for continuing professional development (CPD)• Office space for patient administrationemployment for adults and appropriate domesticsupport for children and adults.5 Delivering a high-quality serviceWhat is a high-quality service?AVPs are medically trained professionals with thehighest level of skills and competencies in the field anddeliver effective and efficient assessment, diagnosis andmanagement of disorders through an MDT in as fewvisits as possible. 12The British Association of Audiological Physicians(BAAP) policy document 2002 13 containsrecommendations for the staff and details of theequipment (less than 5 years old) required for apopulation of 500,000 patients (Tables 1 and 2). Itcovers paediatric and adult vestibular and hearingservices in both community and hospital sites. It alsorefers to the staff required for a team based at a mainunit working across several sites. BAAP published aclinical standards document in 2011 which sets out thegeneric and core standards for working with childrenC○ Royal College of Physicians 2013 39