Designing a paediatric teleotology pilot in the UK: Outcomes from a scoping review of the literature, with insights from the Ear Portal pilot service in Perth, Western Australia.

OBJECTIVE

To inform the design of a United Kingdom (UK) paediatric teleotology pilot by analysing global teleotology initiatives and drawing on insights from a successful paediatric teleotology pilot service in Perth, Western Australia (Ear Portal).

METHODS

A scoping review (January 2014-December 2024) was conducted following PRISMA-ScR guidelines (MEDLINE, Embase) to identify paediatric teleotology service designs, outcomes, and operational frameworks. Eleven studies were included, informing core criteria for a UK pilot. Additionally, a retrospective review of Ear Portal at Perth Children's Hospital (a service for children aged 6-18 years referred with ear disease) examined qualitative data from 149 participants to explore the nature of presenting complaints.

RESULTS

The scoping review identified both asynchronous and synchronous service models, reporting high user satisfaction, cost-efficiency and streamlined clinical pathways. Key criteria for a UK teleotology pilot include Ear, Nose and Throat (ENT) specialist-led triage, video-otoscopy, trained facilitators, and alignment with current National Health Service (NHS) pathways. Non-otological symptoms, such as snoring (59 %) and speech issues (50 %), were frequently reported by Ear Portal participants, reinforcing the need for efficient ENT-led triage and targeted referrals.

CONCLUSIONS

Global evidence and Ear Portal data demonstrate that teleotology can improve access, efficiency, and satisfaction for paediatric ear care. Successful NHS adoption depends on robust diagnostic tools, adequately trained staff, and clear evidence of its cost-effectiveness. We propose recommendations for a UK paediatric teleotology pilot, leveraging both international evidence and real-world data.