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Ear Nose and Throat (ENT) Vestibular Physiotherapy Service

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What is Vestibular Physiotherapy?

The Ear Nose and Throat (ENT) Vestibular service aims to improve the quality of life of people who have developed dizziness and imbalance. The vestibular system is another name for the part of the inner ear which helps us balance, it can make you feel dizzy when this is not working.  The inner ear works alongside your eyes and joints to help us stay upright and balanced.

ENT Vestibular Physiotherapy is a speciality that focuses on problems with dizziness and balance which are not limited to:

It also helps adults and children who develop dizziness as a result of head injury/trauma, strokes, degenerative changes or other causes of inner ear damage.

Through this service, you can be referred onwards to ENT, Falls Service, Day Hospital, or Neurology.

The aim of Vestibular Physiotherapy is to provide evidence-based treatment to improve or help manage your condition. This can be:

Vestibular Rehabilitation

Exercises to help your system return to normal or allow you to adapt and cope with a change in your inner ear or balance system.

Vestibular Manoeuvres

Can be performed in clinic or advised by a health professional to perform at home. These will help BPPV or positional vertigo so are not always needed.

Disclaimer

The information and videos are not a substitute for an assessment, diagnosis, or treatment for a medical condition and any exercises shown are not specific to your medical condition. Please remember if there is any doubt about your fitness for doing these exercises then discuss this with your GP or healthcare professional.

Visit our Balance page for more information on how your balance works and ideas on how to help balance.

Within NHS Lanarkshire Physiotherapy our aim is to provide a website that is designed for you and we want to make it as helpful as possible. We would appreciate it if you could provide us feedback and we will act on it to make improvements through our Feedback Form. Your feedback will be anonymous and will be reviewed by our website development team.

Who works in the ENT Vestibular Service?

The ENT Vestibular Service involves ENT Consultants, Advanced Practice Physiotherapists and Audiologists who work together as a team to provide the best possible care for its patients.

How can I access an ENT Vestibular physiotherapist in NHS Lanarkshire?

There are two ways you can access Vestibular physiotherapy:

  • Your GP may refer you
  • Another Health Care professional may refer you

What happens after ENT receive my referral?

Your details will be added to the ENT Vestibular waiting list based on your clinical need after it is reviewed by a specialist nurse, physiotherapist or ENT consultant. While you are on the waiting list we may send you advice to try to help your symptoms while you are waiting.

Your appointment with a physiotherapist will be carried out via the following method:

  • You will be contacted by post or telephone when you reach the top of our waiting list.
  • Initially, a telephone consultation with your physiotherapist will be offered. Following this appointment, we will either;
    • Give you advice to help manage your condition yourself at home and review your progress by telephone or a “NHS Near Me / Attend Anywhere” video appointment may be agreed and arranged via your physiotherapist if needed
    • Refer you onto a more suitable service to help your symptoms.
    • Invite you to attend an appointment for an assessment with the ENT Vestibular Physiotherapist.
    • Invite you to attend an appointment with the Specialist Audiologist and Advanced Practice Physiotherapist at either University Hospital Hairmyres and Airdrie Health Centre.
    • Arrange a telephone review with an ENT Consultant if needed.
  • If we are able to see from your referral you need to see both an audiologist and physiotherapist you may asked to attend an appointment in our joint clinic as your first appointment. These clinics run at University Hospital Hairmyres and Airdrie Health Centre.

Where do we work?

Find out more

Currently, there are 2 Advanced Practice Physiotherapists assessing patients in NHS Lanarkshire. We are based at the following sites:

  • Alison Lea Health Centre, East Kilbride
  • Airdrie Health centre, Graham Street, Airdrie
  • Houldsworth centre, Wishaw
  • Stonehouse Hospital, Stonehouse
  • Lanark Health centre, Lanark

Your Audiology appointment will either be at University Hospital Hairmyres or Airdrie Health Centre. This will happen at the same time as your Physiotherapy assessment as it is a joint clinic.

Follow-up care and initial appointments may be by telephone or video due to COVID-19 restrictions.

If you need a further appointment with an ENT Consultant, this would be at one of the Acute Hospitals. ENT Consultants work from the main Acute hospitals in Lanarkshire which are:

  • University Hospital Wishaw
  • University Hospital Hairmyres
  • University Hospital Monklands

The ENT Vestibular Service is sometimes not the best place to start managing your condition.

Your GP may wish to rule out other causes of your symptoms and send you to other specialties. Clinicians across NHS Lanarkshire work together to organise your care as effectively as possible.  The Scottish Government has introduced “Right care, right time, right place, right team, every time”, which hopes to improve how patients are seen during their care.

NHS Lanarkshire’s ENT Vestibular Service works closely with the ENT Consultants and has clear referral pathways to help explore your problem further if required. Non-surgical treatment is the best option for many Vestibular problems, however, it is sometimes necessary to explore other investigations or treatments within ENT.

How should I prepare for my ENT Vestibular appointment?

 

Telephone call

  • Please ensure you are beside your phone at the pre-agreed time and ready to take the call.
  • The assessment can take up to 20 minutes so please ensure you have time set aside to complete the assessment.
  • Please ensure you have a list of any medications you are taking.

One-to-one physiotherapy appointment

  • Bring a list of any medications you are taking
  • Wear, or bring suitable clothing so you can move easily and flat shoes so we can look at your balance.
  • Give yourself time after the appointment as some manoeuvres can make you feel dizzy or sick at first. Once this clears it will take your symptoms with it but best to make sure you do not have a busy day and have time to recover. If someone is able to bring you to an appointment this is a good idea.

Joint Specialist Clinic with Audiologist and Physiotherapist

  • Bring a list of any medications you are taking
  • Wear, or bring suitable clothing so you can move easily and flat shoes so we can look at your balance.
  • The appointment will take 40 minutes as both the audiologist and physiotherapist will assess your symptoms.
  • Give yourself time after the appointment as some manoeuvres can make you feel dizzy or sick at first. Once this clears it will take your symptoms with it but best to make sure you do not have a busy day and have time to recover. If someone is able to bring you to an appointment this is a good idea.

What if the appointment is a video call via ‘Near Me’?

You will need a:

  • Charged-up computer, tablet or smartphone with a built-in camera or microphone
  • Quiet, well-lit place where you won’t be disturbed and have space to move around.
  • Good internet connection
How does it work?

Setting up

  • We will e-mail you, or send a letter with your appointment time and any information you need.
  • Make sure you’re familiar with the software before your appointment by testing the before the appointment.
  • Make a list of any questions and/or issues you want to discuss before the video call to help you get the most from your consultation.

Starting the video call

  • Start the video call a few minutes before your appointment by following the link provided in google chrome or safari.
  • You will be asked to confirm your name, date of birth and telephone number so we can call you if we get cut off.
  • Your Physiotherapist will join you when they are ready.

The Consultation

  • You can look at the physiotherapists face while they are talking and we may ask you to carry out movements or watch videos so can assess you. If there are technical issues with picture or sound the physiotherapist will phone you instead.

Ending the video call

  • Ask us any questions you like before you go and the physiotherapist may also ask you to explain your understanding of the diagnosis and agreed treatment plan before ending the call.
  • If another appointment is required the physiotherapist will arrange this
  • You can leave feedback to help us make future consultations better.

Further information can be found on our Near Me page.

What to expect during an ENT Vestibular clinic appointment?

You will be assessed by a Specialist Audiologist who will complete a series of tests. You will then be assessed by an Advanced Practice Physiotherapist who can explore and understand your problem more fully.

We will have a conversation with you then carry out a physical examination to help understand your problem better.

The physiotherapist will want to gain an insight into your perception of the problem. It is very important to discuss your expectations and set realistic goals that physiotherapy can help you achieve at this stage.

The possible treatments will be explained and will be based on the best clinical evidence available. The potential benefits and risks of the treatment options will be discussed. The physiotherapist may also discuss the option and implications of doing nothing.

Possible outcomes of the consultation may include:

  • advice/management plan and a follow-up appointment with a Physiotherapist if required
  • referral to undergo further tests, for example, blood tests, blood pressure checks, scans (not commonly required)
  • being referred to a different specialty e.g. ENT, Day Hospital, falls service

What the Physiotherapist will expect from you?

If you choose to engage with physiotherapy, the expectation is that you will work alongside the physiotherapist and follow your agreed treatment and rehabilitation programme under supervision, as well as on your own at home or in a gym to try and achieve your agreed goals.

Who do I contact if I need to change my appointment?

Please phone the Referral Management Service on 0300 3030 249 as soon as possible if you need to re-arrange or cancel your appointment. They are open Monday to Thursday: 8:00am-7:45pm and on Friday: 8:00am-4:15pm.

What happens if I do not attend my appointment?

If you fail to attend your appointment without contacting us, you will be discharged from the service. If you cancel two consecutive appointments, or three within an episode of care, you will be discharged. Remember each missed appointment costs the NHS at least £136

Your Feedback – comments, concerns and complaints

NHS Lanarkshire is committed to improving the service it provides to patients and their families. We therefore want to hear from you about your experience. If you would like to tell us about this please visit our feedback page.

Near Me Lanarkshire