Introduction: Referrals for OE have increased but the reasons for this remain unclear. We characterise referrals to inform primary secondary care interface improvements. Methods: Questionnaire study from dedicated consultant-led research clinic for OE referrals. Results: 62 patients responded; 63% female, mean age 54 years. One was excluded (not OE). Most had multiple primary care visits before referral (average 4 GP; 2 practice nurse). 60% had received oral antibiotics (16% multiple classes). 18% had never had ear drops. 39% were not advised to keep ears dry. 21% had dermatitis; 13% contact allergy, 30% systemic allergy, 5% diabetes. <10% had narrow canals. 36% had active discharge but <7% needed a wick. Conclusion: OE occurs most commonly in women - often with associated risk factors. Lifestyle advice and ototopical drops are frequently overlooked; instead often inappropriately treated with oral antibiotics. Most ear were anatomically normal and community aural care clinics may have a role in reducing referrals.