28 June 2020

The Rt Hon Matt Hancock MP Secretary of State for Health and Social Care Ministerial Correspondence and Public Enquiries Unit Department of Health and Social Affairs 39 Victoria Street London SW1H 0EU.

Dear Secretary of State,

Re. Urgent action required to authorise the restart of outpatient audiology services as we emerge from COVID-19 pandemic

We write to you as the foremost surgically qualified group in the UK representing patients with hearing loss and balance disorders and the doctors who treat them. The current ‘STOP’ on services is causing both risk and distress.

In light of the COVID-19 pandemic NHSE-I placed a ‘STOP’ on hearing and balance services for adults and children on 19 March 2020. This was changed to ‘PARTIAL STOP’ on 2 April 2020.

BSO were asked by NHSE-I to comment on further updated guidelines on 9 May 2020 which indicated a return to practice was being recommended. We welcomed the release of the updated guidelines for children’s audiology services on 3 June.

I need to advise you of the growing concern from doctors, audiology services and most importantly from our patients that the updated guidelines have still not been released for adult care nearly two months later.

This is causing very severe difficulty for audiology and ENT departments up and down the country – and for our patients. We desperately need our audiologists to be able to restart more routine testing both of hearing loss and imbalance. The backlog of patients awaiting testing is now enormous. This is having a knock-on effect on ENT outpatient services and operating lists. Audiology departments have indicated they do not feel able to restart more normal services until NHSE-I issue the updated guidance.

We have contacted the NHSE-I team whose members have changed recently, but have had no reply.

We ask you to contact the NHSE-I team and make clear their published guidance on return to practice is required immediately.

Re. PPE for patients and staff with hearing loss

We strongly support your efforts to reduce further COVID-19 transmission between staff and patients, and the provision of PPE to meet this goal. However, the use of opaque face masks is causing acute difficulty for both staff and patients who are hard of hearing – that is, 1 in 6 of the adult population. They can no longer use non-verbal cues such as lip reading to communicate. This is now being reported in the mainstream media.

We are unaware of any approved transparent face masks available in the UK. Their supply needs to be addressed urgently. Whilst we believe transparent visors without face masks for clinicians may prove helpful, we are still awaiting guidance. We would value an update on how this is being addressed so we can inform our members and patient support groups.

Our concerns will be released to the media on Friday 5 July 2020 and we would be very grateful for your response before then, so we may include details of any progress on these important issues.

Professor Peter Rea Professor B. Nirmal Kumar Professor Shakeel R. Saeed Mr Tony Narula cc. Professor , CMO cc. Rt Hon MP, Chair, Health and Social Care Committee