Planned for a marathon, but it turned into a sprint – A blog by Tunde Oremulé, ENT Registrar

Tunde Oremulé, ENT (Ear, Nose and Throat) Registrar and Senior Research Fellow at Royal Manchester Children’s Hospital (RMCH) shares his delight in how outstanding teamwork across Manchester University NHS Foundation Trust (MFT) has accelerated plans for research that could break new ground into ways to reduce patient waiting times, widen access to specialist ear healthcare and improve patients’ experience.

Over the past month, I have had the pleasure of working closely with the outpatient nurses and clinic support staff at RMCH on the ACCENTUATE (Acceptability and feasibility of a paediatric teleotology service) research study.

ACCENTUATE is an MFT-sponsored study investigating whether telemedicine appointments (using telephone or virtual meeting software) are acceptable and feasible for children with ear and hearing problems. This type of service delivery is also known as “teleotology” and involves ENT specialists remotely reviewing patient information and making decisions about their care. Teleotology offers a potential way to cut down patient waiting times, widen access to specialist ear healthcare and improve patients’ experience of accessing healthcare, yet teleotology for children and young people in the NHS has not previously been investigated.

During the study, 120 children aged up to 15 years who have glue ear (a condition caused by fluid build-up in the middle ear that can lead to hearing loss and repeated ear infections) and 120 healthy volunteers will undergo ear health assessments. The assessments include a clinical history taken by a member of the research team, an ear examination using a smartphone capable of recording video, a hearing test, and a middle ear pressure test (tympanometry). This information will be remotely reviewed by two independent ENT specialists for its quality and suitability for clinical use, while the recruiting audiologists, ENT specialists, patients and parents will be asked about their experience of the process. We will use this information to inform the design of a pilot study of a teleotology service for children at MFT.

Our original plan was to recruit the 240 participants over the course of a year – 120 children with glue ear in the community and 120 healthy volunteers at RMCH, but thanks to the outstanding dedication and teamwork of the lead nurses and clinic support staff, we reached our recruitment target of 120 healthy volunteers in just one month!

Why this matters

• We are breaking new ground in understanding telemedicine’s role for children with ear and hearing issues.
• We are showing that when clinical teams work in collaboration, even the most ambitious timelines can be surpassed.

This rapid progress means that we can devote additional resources to our community recruitment sites at Trafford General Hospital, part of MFT, and Moss Side Health Centre, where audiologists are currently recruiting the remaining 120 children who have glue ear. Glue ear is more prevalent in the autumn and winter months. With the change of seasons, and the continued enthusiasm of our clinical teams, I am confident we will continue to excel in our recruitment of this cohort too.

This study would not be possible without competitive research funding awarded by Research and Innovation at MFT (Peter Mount Clinical Pump-Prime Award 2021), Tympa Health Ltd, the National Institute for Health and Care Research (NIHR) Manchester Biomedical Research Centre, Health Innovation Manchester (Momentum Award) and the ENT UK Foundation.

The journey continues and I could not be prouder of the progress we are making. We expect to complete the research within 12 months and will share our findings with our service users, and with the wider medical community in journal publications and conferences. Thank you to everyone who has been part of this incredible journey.

If you would like to know more, or have any questions or comments, please reach out to me at ACCENTUATE@mft.nhs.uk.