The Audiology Clinical Care Programme

The National Audiology Review Group has developed a comprehensive set of recommendations to address the inconsistencies and inadequacies in audiology services, Aisling Heffernan, told the HMI Forum organised by the HMI Dublin Mid Leinster Regional Committee and held in the Dublin Dental University Hospital.

The HSE published the report of its National Audiology Review Group (NARG) on April 13 last. The work undertaken by NARG constitutes the most extensive examination to date of audiology services in Ireland. The NARG examined audiology services currently provided to children and adults nationwide and undertook an extensive public consultation and assessed the needs of the population. It found that better use of existing resources, coupled with additional funding, improved education and training, and integration of services across hospital and community settings will deliver better value for money and represent a long term investment in providing the best possible care, with improved health and social outcomes for clients.

The NARG has developed a comprehensive set of recommendations to address the inconsistencies and inadequacies in audiology services. Arising from the recommendations of the NARG, work is now underway to improve access and deliver high quality, consistent audiology services around the country.  The report identified some inconsistencies and shortcomings in audiology services around the country including access issues, poor information, inadequate staffing levels, poor infrastructure and waiting times which have reached unacceptable levels in some areas.

The report identified some inconsistencies and shortcomings in audiology services around the country, including access issues, poor information, inadequate staffing levels, poor infrastructure and waiting times which have reached unacceptable levels in some areas.

The key recommendations made by the NARG include:

  • The implementation of a National Newborn Hearing Screening Programme.
  • Improvements in hearing aid and ear mould services.
  • A restructuring of services and staffing to provide better integrated teams, with enhanced communication between professionals and patients.
  • The appointment of a national clinical lead for audiology and four regional clinical leads to deliver the modernisation programme, and to implement new care pathways and improved clinical governance.
  • A workforce review to confirm the extent of the required uplift of numbers of audiology professionals.
  • Establishment of within-country training for audiology professionals, with professional registration.

The UK NHS Audiology service is the biggest procurer of hearing aids in the world and linking in with our UK procurement colleagues will result in achieving the best value for money in our procurement process

Progress on Implementation of Recommendations

Indeed, since publication, much progress has been achieved on the implementation of recommendations, in summary these include:

  • Establishment of an Audiology Clinical Care Programme under the Clinical Strategy Programme.
  • National and Regional Clinical Leads – Job specifications have been agreed and issued to the Department of Health and Children.  They are now linking with the Department of Finance on the approval of these posts.  Every effort is being made from the HSE perspective to secure approval for these critical posts.  These posts will provide the clinical governance required for the development of the service going forward including the roll out of Newborn Hearing Screening.  Prof. John Bamford provides direction under the remit of Interim National Clinical Lead on a part-time basis.
  • The Audiology Programme, Project Manager is now in post. This post is pivotal to the implementation of recommendations and developments going forward.
  • Regional Managerial Leads have been nominated by each RDO to progress implementation regionally (in the absence of clinical leads).
  • 2011 Development Funding was released to services, this supported the following initiatives;
    • Sponsorship of candidates to pursue an accelerated MSc in Audiology in the UK.
    • Sponsorship of current audiology staff to upskill in preparation for the rollout of Universal Newborn Hearing Screening.
    • Completion of the rollout of UNHS in HSE South.
    • Additional funding was provided for national hearing aid budget.
  • Audiology staff briefing sessions were held in each HSE Region which afforded staff and local managers to raise issues or seek clarifications on recommendations within the report.
  • Formal information sharing meetings with IMPACT – formal meetings have been convened with IMPACT in relation to the report and the implementation of its recommendations.  A commitment to continued communication was given and will be complied with.
  • Universal Newborn Hearing Screening – Newborn hearing screening is now in place in Cork University Maternity Hospital, Wexford and Waterford maternity hospitals.  The screen is being provided by an external contractor but all components of the screen is in compliance with the national model for newborn hearing screening as recommended by the NARG.  The coverage of these maternity hospitals in HSE South will provide coverage to approximately 19,384 births (including home births) representative of an average of 26 per cent of the national birth rate.  South Tipperary and Kilkenny have established the required planning local implementation groups with screening expected to commence in early 2012 (funding dependent).  Planning is also underway to extend the programme to a further region in 2012 (funding dependent).
  • Revised procurement framework for hearing aids and accessories – the current hearing aid tender is due for renewal in 2012.  The UK NHS Audiology service is the biggest procurer of hearing aids in the world and linking in with our UK procurement colleagues will result in achieving the best value for money in our procurement process.
  • Initial discussions were held with colleagues in the Department of Social Protection to address the duplication of funding between the Hearing Aid Grant Scheme funded via Social Protection and HSE Hearing Aid position.
  • Initial discussions were also held with colleagues in the Department of Education and Skills on how best to meet the needs of younger children going forward as a result of the phased roll out of newborn hearing screening.
  • A workforce planning exercise has now been completed. The findings indicate that an approximate doubling of the current workforce is required.  In addition, a proposal for a unified career structure for all audiology staff, existing and new has been developed. Both recommendations are currently being pursed with senior HSE Management.

The Audiology Clinical Care Programme looks forward to continuing improvements and progress in 2012. Please see our new website at www.hse.ie/go/audiology

Aisling Heffernan is currently the Speech & Language Therapy Manager at the National Rehabilitation Hospital and is on a part time secondment to the HSE to work as Programme Manager for Audiology.