The specialist vestibular pathway within East Lothian Rehabilitation Service (ELRS) provides comprehensive assessment and targeted rehabilitation for individuals presenting with symptoms suggestive of a vestibular disorder or dysfunction.
The service is delivered by Advanced Practice Physiotherapists (APPs) and experienced physiotherapists, offering evidence‑based management and rehabilitation aimed at reducing dizziness, improving balance, and supporting functional independence.
All referrals are triaged by the team and directed to the most appropriate service. Appointments are currently available at East Lothian Community Hospital (ELCH) only.
M.A & C.F – 06-05-26
Who can refer
Primary Care:
GP’s, Practice Nurses, ANP’s with SCI Gateway access
Secondary Care:
MOE Consultants
AHP’s:
Acute Physiotherapists, Community AHP’s within the wider East Lothian Rehabilitation Service
Patients/Carers/Family members:
Self-referral is available to all East Lothian residents
Who to Refer
BPPV
- Short-lived, recurrent vertigo (sense that your surroundings are spinning or moving) – usually associated with changes in head position e.g. turning over in bed, bending over and standing up
- May be associated with falls
- Consider a Dix-Hallpike +/- Epley manoeuvre prior to referral (There are some links on the ENT RefHelp BPPV page)
Vestibular neuritis/ Labyrinthitis where a diagnosis has been made and other causes excluded (eg a central cause such as stroke) but ongoing vestibular rehabilitation would be helpful
- Sudden onset of persistent disabling vertigo
- Unsteadiness/ falls
- Nausea/ vomiting
- Possible hearing loss and/ or tinnitus
Who not to refer:
- Acute onset of persistent vertigo in a patient with abnormal neurology or significant stroke risk factors – refer urgently via Flow centre for stroke/ neurology assessment
- Patients with red flag ENT symptoms such as ear pain, alterations in hearing, symptoms suggestive of infection (see ENT RefHelp BPPV page for more details.
- Patients with multimorbidity who would benefit from a comprehensive review by a geriatrician
How to refer:
Primary Care Pathway:
Referrals should be made via SCI Gateway:
AHP – Physiotherapy
East Lothian – East Lothian Rehabilitation Service
LI Physiotherapy
FAO: vestibular team
Secondary Care:
MOE consultants can refer via email to eastlothianphysioreferrals@nhslothian.scot.nhs.uk
AHPs:
Email referrals accepted to: eastlothianphysioreferrals@nhslothian.scot.nhs.uk
Patient Self-Referral:
Patient/family member/carer can call ELRS Single Point of Contact Phoneline on 0300 3690680 to self-refer for a falls assessment
