A study of out-of-hours facilities in otolaryngology: current provision and problems

Action on ENT' has recently published advice as to the minimum requirements for equipment required to provide a safe and suitable out-of-hours service in ENT. Our objectives were to determine the availability of a dedicated ENT treatment room for seeing patients out of hours, appropriately maintained specialized ENT equipment and availability of appropriate assistance. In addition, the mechanism for disinfection of nasoendoscopes out of hours was determined. Telephone questionnaires of 106 ENT units in England, which provide an out-of-hours ENT service, were taken. At each unit the standard questionnaire was answered by the first on-call ENT doctor. One hundred and one units (95 per cent) had access to a dedicated treatment room out of hours. The number of units with a microscope was 91 (86 per cent), headlight/lamp and mirror was 105 (99 per cent), flexible nasoendoscope was 86 (81 per cent) and cautery (electrical or chemical) was 105 (99 per cent). Seventy-nine units (75 per cent) found that their treatment rooms were adequately stocked, and 62 units (58 per cent) bad assistance available when needed. Twenty-four units (23 per cent) sterilized their scopes adequately, 22 units (21 per cent) used endosheaths, 26 units (24 per cent) used a variety of inadequate cleaning methods, and 34 respondents (32 per cent) were unsure how their scopes were cleaned. This survey has shown that not all ENT units have appropriately equipped out-of-hours facilities. There is a need for nationally agreed guidelines stating the minimum equipment and assistance required to provide a safe, adequate and suitable out-of-hours service. National guidelines on out-of-hours disinfection of flexible nasoendoscopes are also required.