{"id":27808,"date":"2026-05-06T09:13:26","date_gmt":"2026-05-06T08:13:26","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=27808"},"modified":"2026-06-18T14:15:38","modified_gmt":"2026-06-18T13:15:38","slug":"east-lothian-vestibular-pathway","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/east-lothian-vestibular-pathway\/","title":{"rendered":"East Lothian Vestibular Pathway"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">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.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The service is delivered by Advanced Practice Physiotherapists (APPs) and experienced physiotherapists, offering evidence\u2011based management and rehabilitation aimed at reducing dizziness, improving balance, and supporting functional independence.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">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.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1229\" height=\"704\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/East-Lothian-Vestibular-Pathway-flowchart.png\" alt=\"East Lothian Vestibular Pathway flowchart\" class=\"wp-image-27809\" style=\"aspect-ratio:1.7457660551751346;width:806px;height:auto\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/East-Lothian-Vestibular-Pathway-flowchart.png 1229w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/East-Lothian-Vestibular-Pathway-flowchart-300x172.png 300w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/East-Lothian-Vestibular-Pathway-flowchart-1024x587.png 1024w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/East-Lothian-Vestibular-Pathway-flowchart-768x440.png 768w\" sizes=\"auto, (max-width: 1229px) 100vw, 1229px\" \/><figcaption><span class=\"media-credit\">NHS Lothian<\/span><\/figcaption><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><strong>M.A &amp; C.F &#8211; 06-05-26<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who can refer<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Primary Care:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">GP\u2019s, Practice Nurses, ANP\u2019s with SCI Gateway access<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Secondary Care:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">MOE Consultants<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>AHP\u2019s:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Acute Physiotherapists, Community AHP\u2019s within the wider East Lothian Rehabilitation Service<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Patients\/Carers\/Family members:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Self-referral is available to all East Lothian residents<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who to Refer<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">BPPV<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Short-lived, recurrent vertigo (sense that your surroundings are spinning or moving) \u2013 usually associated with changes in head position e.g. turning over in bed, bending over and standing up<\/li>\n\n\n\n<li>May be associated with falls<\/li>\n\n\n\n<li>Consider a Dix-Hallpike +\/- Epley manoeuvre prior to referral (There are some links on the <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/audiology\/bppvbenignparoxysmalpositionalvertigo\/\" target=\"_blank\" rel=\"noreferrer noopener\">ENT RefHelp BPPV page<\/a>)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">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<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Sudden onset of persistent disabling vertigo<\/li>\n\n\n\n<li>Unsteadiness\/ falls<\/li>\n\n\n\n<li>Nausea\/ vomiting<\/li>\n\n\n\n<li>Possible hearing loss and\/ or tinnitus<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Acute onset of persistent vertigo in a patient with abnormal neurology or significant stroke risk factors \u2013 refer urgently via Flow centre for stroke\/ neurology assessment<\/li>\n\n\n\n<li>Patients with red flag ENT symptoms such as ear pain, alterations in hearing, symptoms suggestive of infection (see <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/audiology\/bppvbenignparoxysmalpositionalvertigo\/\" target=\"_blank\" rel=\"noreferrer noopener\">ENT RefHelp BPPV page<\/a>\u00a0for more details.<\/li>\n\n\n\n<li>Patients with multimorbidity who would benefit from a comprehensive review by a geriatrician<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Primary Care Pathway:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Referrals should be made via SCI Gateway:<br>AHP \u2013 Physiotherapy<br>East Lothian \u2013 East Lothian Rehabilitation Service<br>LI Physiotherapy<br>FAO: vestibular team<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Secondary Care:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">MOE consultants can refer via email to&nbsp;<a href=\"mailto:eastlothianphysioreferrals@nhslothian.scot.nhs.uk\" target=\"_blank\" rel=\"noreferrer noopener\">eastlothianphysioreferrals@nhslothian.scot.nhs.uk<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>AHPs:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Email referrals accepted to:&nbsp;<a href=\"mailto:eastlothianphysioreferrals@nhslothian.scot.nhs.uk\" target=\"_blank\" rel=\"noreferrer noopener\">eastlothianphysioreferrals@nhslothian.scot.nhs.uk<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Patient Self-Referral:<\/strong> <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Patient\/family member\/carer can call ELRS Single Point of Contact Phoneline on 0300 3690680 to self-refer for a falls assessment<\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>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&#8209;based management and rehabilitation aimed at reducing dizziness, improving balance, and supporting functional independence.<\/p>\n","protected":false},"author":20,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[859,1387],"class_list":["post-27808","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-east-lothian-rehabilitation-service-elrs","category-https-apps-nhslothian-scot-refhelp-east-lothian-vestibular-pathway"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"mariamazoysaavedra","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/mariamazoysaavedra\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/rehabilitation\/https-apps-nhslothian-scot-refhelp-east-lothian-rehabilitation-service-elrs\/\" rel=\"tag\">East Lothian Rehabilitation Service (ELRS)<\/a><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/rehabilitation\/https-apps-nhslothian-scot-refhelp-east-lothian-rehabilitation-service-elrs\/https-apps-nhslothian-scot-refhelp-east-lothian-vestibular-pathway\/\" rel=\"tag\">East Lothian Vestibular Pathway<\/a>","rttpg_excerpt":"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&#8209;based management and rehabilitation aimed at reducing dizziness, improving balance, and supporting functional independence.","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27808","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=27808"}],"version-history":[{"count":6,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27808\/revisions"}],"predecessor-version":[{"id":27823,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27808\/revisions\/27823"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=27808"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=27808"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}