Barriers to CI Referral
The ageing population and new changes to the NICE criteria mean that there is likely to be an increase in numbers of people who could be referred for CI. By better understanding and addressing the reasons for low referral and uptake of CI, more people could maximise their hearing and benefit from the resulting impact on their health and well-being.
This study explored the barriers to adult CI uptake from the perspective of audiologists working in non-CI clinics and it identified the factors, which facilitate referral. Strengthening the knowledge, confidence and training (particularly in counselling)of audiologists involved in the referral process for CI, combined with a more cohesive system of referral and more flexible criteria could considerably change the quality of the referral process. Increasing awareness of the cochlear implant process, greater sharing of knowledge and a closer relationship between CI Centres and the referring professionals could also enhance the process.
The following recommendations are based on these findings.
- Increased awareness not only among audiology staff, but also in the general public, primary care and other healthcare professionals of the known significant benefits of hearing for healthy ageing and the availability of CI
Training to strengthen the knowledge and confidence of audiologists, for example through
- Regular information and updates about CI technology, pathway and outcomes from CI teams and manufacturers
- Audiologists educators, Universities with approved/accredited courses
- Peer support, such as regional network meetings
- Increased counselling and communication skills
- Collaborative working between non-CI audiology services and CI centres, for example
- Increasing activity at a local level, for example CI teams providing local appointments for patients; devolving CI assessments to the non-CI service
- Feedback to non-CI audiology about referred patients
- Discussion about individual cases
- Peer group meetings for sharing knowledge and networking.
- Considering the whole pathway from audiology to CI to reduce barriers and increase facilitators, such as using standardised checklists, clinical guidance and referral forms
- Access to user groups for adults considering CI and post operatively to aid the transition process