Inappropriate referrals to the physiotherapist led ent balance clinics across Merseyside in the United Kingdom: A retrospective audit using Plan, Do, Study, Act.

Introduction: Dizziness and vertigo symptoms have a 10-30% prevalence in the United Kingdom (UK), approximately 25% of referrals to ENT cite dizziness or imbalance. Poor quality referrals lead to growing waiting lists, patients waiting longer for diagnosis and delays in treatment leading to potential development of chronic dizziness, imbalance and falls. Aim: Undertake a retrospective audit to identify the appropriateness of referrals to the local physiotherapist led ENT balance clinics Method: Retrospective ‘plan, do, study, act’ audit of referrals and diagnostic outcomes was undertaken. Results: All referrals stated dizziness, vertigo or imbalance as the reason for referral but after assessment 21/100 were identified as not appropriate. Discussion: There are limitations in the current referral process. The development of a local standardized dizziness pathway, particularly focusing on addressing orthostatic hypotension and vestibular migraine in primary care may be beneficial. Conclusion: Orthostatic hypotension is the most likely condition to be inappropriately referred.