Creating a community leadership role for non-complex ENT care

Introduction: In Ireland, 68,000 patients are waiting for their first Ear, Nose & Throat (ENT) outpatient (OPD) appointment. One third of referrals pertain to non-complex ENT conditions. Community-based delivery of non-complex ENT care would facilitate access in a timely manner, locally. Despite the creation of a micro-credentialling course, community practitioners have encountered barriers to implementing their newly acquired expertise, including a lack of peer support and subspecialty resourcing.

Method: In 2020, funding was secured through the National Doctors Training and Planning Aspire Programme for a fellowship for ENT Skills in the Community, credentialled by the Royal College of Surgeons in Ireland. The fellowship was open to newly qualified GPs with the aim of developing community leadership in ENT, providing an alternative referral resource, providing peer education and creating an advocate for the further development of community-based subspecialists.

Results: The fellow started in July 2021 and is based in the Ear Emergency Department at the Royal Victoria Eye and Ear Hospital, Dublin. They have been exposed to non-operative ENT environments, developing diagnostic skills and treating a range of ENT conditions through the utilisation of microscope examination, microsuction and laryngoscopy. Multiplatform educational engagements have provided teaching experience including publications, webinars reaching approximately 200 healthcare workers each and GP-trainee workshops. The fellow has been facilitated in building relationships with key policy stakeholders and is presently working on a bespoke e-referral pathway.

Discussion: Promising early results have secured funding for a second fellowship. Key to the success of the fellowship role will be will be ongoing engagement with hospital and community services.