National Audiology Review Group

A reference group, consisting of key stakeholders, was set up to ensure views were understood and properly considered during the review, and that its recommendations were written with a view to understand the lived experience of people living with sensory loss and their carers and families.

Terms of reference

Background

In March 2022 the Cabinet Secretary of Health and Social Care appointed Professor Jacqueline Taylor to the role of an Independent Chair to provide leadership to an Independent Review of Audiology Services in Scotland.

The Independent Chair has established a National Audiology Review Reference Group (the Reference Group) to represent stakeholder streams that are required to be consulted during the review.

Purpose and role

The purpose of the reference group is to ensure that stakeholder views are understood and properly considered during the Independent Review of Audiology, and to enhance engagement between the National Audiology Review Group and its diverse stakeholders.

The role of the reference group is to:

• provide advice and guidance on consultation methods to the review group
• support, encourage and facilitate the participation of stakeholders in engaging with the review
• ensure the views of those who use audiology services are understood and taken into account by the review group
• assist in the dissemination of information and communications to support the review processes

The reference group is an advisory group and does not have decision making authority. 

Process

During the course of the review, it is intended that the reference group will:

• be chaired by Angela Bonomy, Chief Executive of Sense Scotland
• be provided secretariat support by the Scottish Government
• convene three or four times for meetings of up totwo hours duration
• provide structured opportunities for stakeholder engagement

Transparency

In the interests of transparency, these reference group terms of reference and the names of nominated members will be published on the Scottish Government website. 

Membership

The reference group is comprised of:

• Angela Bonomy (Chair), Chief Executive Officer, Sense Scotland, third sector/Scottish audiology sector  
• Rob Geaney, Team lead for campaigns and external affairs, Royal National Institute for Deaf People, third sector/lived experience
• Mark Ballard, Head of Policy and Influencing for Scotland, National Deaf Children’s Society, third sector/lived experience
• Dr Miles Mike, Chair of Scottish Academy, Scottish Academy, multidisciplinary
• Dr Brian Shannon, Educational Audiologist, Scottish Sensory Centre, teacher of the deaf workforce 
• Susan Campbell, Newborn Hearing Programme Clinical Lead, National Services Scotland, National Services Division, Clinical pathway/early intervention and prevention
• Jane Gallacher, SaLT CEN and SCIP, Scottish Cochlear Implant Service (SCIP), Clinical pathway/speech and language therapy workforce
• anonymous, service user, lived experience - adults
• anonymous, adult hearing aid user, lived experience - adults
• anonymous, parent, lived experience – paediatrics 

This subgroup sought to provide a quality assurance appraisal of services, survey key elements of existing service provision - with a particular focus on issues impacting on patient outcomes; and review existing quality assurance arrangements - making recommendations necessary to establish robust quality assurance processes, whilst progressing service quality, improvement and outcomes for patients on a permanent basis.    

Terms of reference

Background

In January 2022 the Cabinet Secretary of Health and Social Care announced a National Audiology Review would be established to examine hearing services provided to both children and adults in health boards across Scotland. The group will provide recommendations for the improvement of the service.

The Independent Review of Audiology was announced following the publication of an Independent Review into the Paediatric Audiology Service in NHS Lothian, carried out by the British Academy of Audiology (BAA) in response to a complaint upheld by the Scottish Public Services Ombudsman (NHS Lothian Full BAA statement and reports, British Academy of Audiology).

In March 2022 the Cabinet Secretary for Health and Social Care appointed Professor Jacqueline Taylor to the role of an Independent Chair to provide leadership to the National Audiology Review Group.

Purpose and role

The purpose of all working groups is to support the National Audiology Review Group in making recommendations to improve audiology services in Scotland. The remit of the working group will include:

• assurance on current provision of paediatric and adult audiology services including diagnostics and treatment
• ongoing clinical audit, quality assurance, standards, peer review and data collection
• relationship with arrangements for governance of audiology services in Scotland

In scope: data collection

Out of scope: individual cases, review of caseload

The review group may consider previous and ongoing work in this area, including:

• the See Hear Strategy currently being taken forward by the Scottish Government
• progress with the Universal Newborn Hearing Screening Programme
• work undertaken by the Scottish Heads of Audiology Group and Hearing Impairment Network for Children and Young People in consideration of any identified opportunities for improving audiology services
• recommendations proposed by the National Deaf Children’s Society and any work undertaken by wider partners

It is to be noted that the review group will not immediately consider issues around regulation of audiologists as this is subject of a recent UK-wide consultation. Any implications that might arise from the outcome could be considered by the review group if appropriate or necessary.

Membership

Membership will reflect key stakeholders across the clinical pathway across the healthcare system and areas of consideration for the work of the review. Membership will reflect key stakeholders at the invitation of the Chair. 

The working group is comprised of:

• John Day, Clinical Director of Audiology (Chair), NHS Wales
• Sandra McDougall, Deputy Director of Quality Assurance, HealthCare Improvement Scotland (HIS)
• Dr Sam Lear, Senior Audiology Advisor, National Deaf Children’s Society 
• Crystal Rolf, Associate Director for Strategy – Health, Royal National Institute for Deaf People 
• Susan Campbell, Clinical Lead, Newborn Hearing Screening Programme
• Kieran Joseph, The British Academy of Audiology (BAA)
• Donna Corrigan, Chair of BSA, The British Society of Audiology (BSA)
• Laura Turton, Adult Audiology Specialist, Scottish Heads of Audiology 
• Ruth Edgar, Paediatric Audiology Specialist, Scottish Heads of Audiology 
• Jane Gallagher, Speech and Language Therapist, Scottish Cochlear Implant Programme 

Scottish Government: Representatives of Scottish Government policy teams may sit on this group as official observers.

Membership will be kept under review and the roles and responsibilities of the members will be set by the Chair.

Meetings 

The working group meeting schedule will be confirmed by the Chair. Frequency and timing of meetings will be kept under review to maintain delivery of remit.

The Chair has discretion to set the format of any meetings in a way that best suits the subject matter for discussion, having taken into account the views of working group members or ad hoc participants. As needed, the Scottish Government can provide physical meeting rooms for the purposes of in-person or hybrid meetings. 

Minutes for each meeting will be taken by a member of the review secretariat team at the Scottish Government, who is providing secretariat support. 

Communications and information sharing

In line with independence but reflecting the Scottish Government’s contribution to the review’s work as secretariat, the Scottish Government will establish secure record keeping mechanisms that keep material relating to the review group separate from general information held by the Scottish Government. This will make clear that, for the purposes of FOISA, the Scottish Government is holding this information on behalf of the review.

The Scottish Government, including in its role as secretariat to the review group, is subject to requests for information under FOISA. This means that material provided to officials acting in a secretariat role by the review group would be information held by the Scottish Government for the purposes of FOISA. In the event of a request for information being received the Scottish Government would, in the usual way, consider if any exemptions applied to the release of the information. Consideration of exemptions may involve the application of the public interest test. 

The Scottish Government in its secretariat role will ensure that any data is processed in compliance with the UK General Data Protection Regulations and the Data Protection Act 2018. 

To support public understanding of the work of the review group, the Scottish Government in its secretariat role will publish terms of reference, high level work plan and minutes of meetings. The review group will consider the publication of other information where appropriate. 

Otherwise, review group discussions are confidential. Review materials and any information about the subjects discussed are confidential and not to be shared with third parties.

Outputs

Arising recommendations will be provided to the National Audiology Review Group within the timescales the working group deems necessary. 

It is expected each working group will produce an overall summary and findings section with relevant recommendations.

The Chair will also provide a written update on behalf of the working group to Professor Jacqueline Taylor at regular intervals. 

Secretariat

The Scottish Government in its secretariat role to the Chair and review group will prepare meeting papers, and generally advise and provide support to enable groups to operate effectively. 

This subgroup reviewed current structures, and the governance and leadership of paediatric and adult audiology services.

Terms of reference

Background and strategic context 

In January 2022 the Cabinet Secretary of Health and Social Care announced a National Audiology Review would be established to examine hearing services provided to both children and adults in health boards across Scotland, to ensure public confidence in the quality and effectiveness of current service provision. The group will provide recommendations for a national plan for improvement of the service and its specific purpose and scope has been detailed below.

The Independent Review of Audiology comprises specific enquiries into: 

• current structure, governance and leadership of paediatric and adult audiology services
• current clinical audit, quality assurance, standards, peer review and data collection
• current education and training and continued professional development provision
• the lived experience of people living with sensory loss and their carers and families

This term of reference specifically relates to structure, governance and leadership.

Purpose and role

The purpose of all subgroups is to support the National Audiology Review Group in making recommendations to improve audiology services in Scotland. 

The remit of the Structure, Governance and Leadership subgroup will include:

• reviewing the structure of audiology services in NHS Scotland with a specific focus on the existing local and national governance arrangements and the provision of advice and recommendations in regard to any identified gaps at both local and national levels
• establish the current situation with regard to professional leadership for paediatric and adult audiology services and requirements for further development

The subgroup may consider previous and ongoing work in this area, including:

• progress with the Universal Newborn Hearing Screening Programme
• work undertaken by the Scottish Heads of Audiology Group and Hearing Impairment Network for Children and Young People in consideration of any identified opportunities for improving audiology services
• recommendations proposed by the National Deaf Children’s Society and any work undertaken by wider partners
• the Scottish Audiology Quality Standards for Adult Rehabilitative Audiology and the Scottish Audiology Quality Standards for Paediatric Audiology Services

It is to be noted that the subgroup will not immediately consider issues around regulation of audiologists as this is subject of a recent UK wide consultation. Any implications that might arise from the outcome could be considered by the Working Group if appropriate or necessary.

Approach and review process

The subgroup will identify strengths and weaknesses in Scotland for current arrangements concerning:

• local clinical governance structures
• national governance arrangements
• clinical leadership structure
• multi-disciplinary working across the clinical pathway for children and people affected by sensory loss
• intersection with Quality Assurance of the service and
• the role of National Managed Clinical Networks

Out of scope: Leadership development for audiologists is considered out of scope for the work of this subgroup and it is recognised this may be considered more broadly as a part of the remit of the Education and Training subgroup.

Deliverables

The subgroup Chair will provide a written update on behalf of the subgroup to Professor Jacqueline Taylor and the wider National Audiology Review Group at regular intervals. 

The subgroup will produce a brief report in time for the National Oversight Review Group’s consideration and for incorporation into its own final report to Scottish Government. 

This report will recommend potential solutions for structure, governance and leadership for audiology using an options appraisal approach.

Communications and information sharing

In line with independence but reflecting the Scottish Government’s contribution to the review’s work as secretariat, the Scottish Government will establish secure record keeping mechanisms that keep material relating to the working group separate from general information held by the Scottish Government. This will make clear that, for the purposes of FOISA, the Scottish Government is holding this information on behalf of the review.

The Scottish Government, including in its role as secretariat to the working group, is subject to requests for information under FOISA. This means that material provided to officials acting in a secretariat role by the working group would be information held by the Scottish Government for the purposes of FOISA. In the event of a request for information being received the Scottish Government would, in the usual way, consider if any exemptions applied to the release of the information. Consideration of exemptions may involve the application of the public interest test. 

The Scottish Government in its secretariat role will ensure that any data is processed in compliance with the UK General Data Protection Regulations and the Data Protection Act 2018. 

To support public understanding of the work of the Education and Training subgroup, the Scottish Government in its secretariat role will publish terms of reference, high level work plan and minutes of meetings. The Education and Training subgroup will consider the publication of other information where appropriate.

Otherwise, subgroup discussions are confidential. Review materials and any information about the subjects discussed are confidential and not to be shared with third parties.

Timescales and meeting schedule

The Independent Review of Audiology is due to report at the end of a nine-month project, commencing May/June 2022; the Structure, Governance and Leadership subgroup will complete its deliberations in sufficient time to allow the National Audiology Review Group to critique the findings and request any further input.

Meetings of the Structure, Governance and Leadership subgroup will be virtual and approximately six-weekly, in-between the wider review group’s meetings.

Minutes for each meeting will be taken by a member of the review secretariat team at the Scottish Government, who is providing secretariat support. 

Membership

Membership will reflect key stakeholders at the invitation of the Chair.

The Sub-Group is comprised of:

• Adrian Carragher, Chair, Head of Audiology, NHS Ayrshire and Arran
• Jane Wild, Consultant Clinical Scientist and Head of Adult Audiology, Betsi Cadwaladr University Health Board (BCUHB), NHS Wales
• Kathryn Lewis, President, British Academy of Audiology
• Dr Brian Shannan, Service Manager of Deaf Children Service, NHS Fife, Teachers of the Deaf
• Arlene O’malley, Clinical Scientist, The Scottish Cochlear Implant Programme (SCIP)
• Dr Andrew Murray, Medical Director, NHS Forth Valley
• Mark Mitchell, Head of Service, NHS Grampian
• Crystal Rolfe, Associate Director, Health Programme Royal National Institute of the Deaf (RNID)
• Lyn Hutchison, National Services Scotland (NSS), National Specialist and Screening Services Directorate (NSD)

Representatives of Scottish Government policy teams for the Community Hearing Service may sit on this group as official observers.

Membership will be kept under review and the roles and responsibilities of the members will be set by the Chair.

Secretariat

The Scottish Government in its secretariat role to the Chair and working group will prepare meeting papers, and generally advise and provide support to enable groups to operate effectively. 

This subgroup reviewed current education and training and continued professional development provision.

Terms of reference

Background and strategic context

In January 2022 the Cabinet Secretary of Health and Social Care announced a National Audiology Review would be established to examine hearing services provided to both children and adults in health boards across Scotland. The group will provide recommendations for the improvement of the service.

The Independent Review of Audiology comprises specific enquiries into: 

• current structure, governance and leadership of paediatric and adult audiology services
• current clinical audit, quality assurance, standards, peer review and data collection
• current education and training and continued professional development provision
• to understand the lived experience of people living with sensory loss and their carers and families

This term of reference specifically relates to the review of current education and training and continuing professional development provision.

Purpose and scope

The purpose of all subgroups is to support the National Audiology Review Group in making recommendations to improve audiology services in Scotland. 

The remit of the Education and Training subgroup will include:

• the current pathways for pre and post registration audiological clinical physiologists/clinical scientists, and recommend to the National Audiology Review Group areas for improvement

Out of scope: consideration of workforce supply and demand will inform the discussion but the development of a comprehensive workforce model or plan is not expected to be a necessary part of the subgroup’s work.

Approach and review process

The subgroup will identify strengths and weaknesses in Scotland for current arrangements concerning:

• pre-registration training of audiologists
• post-registration training of audiologists
• systematic continued professional development (CPD)
• the intersection of education and training with the quality assurance of service
• the role of networks and communities of practice in supporting fitness to practise, including adverse incident detection and reporting
• the role of audiologists in supporting competence of other professions who may undertake audiological tests such as newborn screening

It is anticipated that the subgroup will debate the merits of current arrangements in terms of what we currently have in Scotland, what is good, less good and what is practically needed.

Deliverables

The Chair will provide a written update on behalf of the subgroup to Professor Jacqueline Taylor and the wider National Audiology Review Group at regular intervals. 

The Education and Training subgroup will produce a “state of training” report with recommendations in time for the National Audiology Review Group’s consideration and for incorporation into its own final report to Scottish Government.

The state of training report will recommend potential solutions to education and training for audiology using an options appraisal approach.

Communications and information sharing

In line with independence but reflecting the Scottish Government’s contribution to the review’s work as secretariat, the Scottish Government will establish secure record-keeping mechanisms that keep material relating to the subgroup separate from general information held by the Scottish Government. This will make clear that, for the purposes of FOISA, the Scottish Government is holding this information on behalf of the review.

The Scottish Government, including in its role as secretariat to the subgroup, is subject to requests for information under FOISA. This means that material provided to officials acting in a secretariat role by the subgroup would be information held by the Scottish Government for the purposes of FOISA. In the event of a request for information being received the Scottish Government would, in the usual way, consider if any exemptions applied to the release of the information. Consideration of exemptions may involve the application of the public interest test. 

The Scottish Government in its secretariat role will ensure that any data is processed in compliance with the UK General Data Protection Regulations and the Data Protection Act 2018. 

To support public understanding of the work of the Education and Training subgroup, the Scottish Government in its secretariat role will publish terms of reference, high level work plan and minutes of meetings. The Education and Training subgroup will consider the publication of other information where appropriate.

Otherwise, subgroup discussions are confidential. Review materials and any information about the subjects discussed are confidential and not to be shared with third parties.

Timescales and meeting schedule

The Independent Review of Audiology is due to report at the end of a nine-month project, commencing May/June 2022; the Education and Training subgroup will complete its deliberations in sufficient time to allow the National Review Group to critique the findings and request any further input.

Meetings of the Education and Training subgroup will be virtual and approximately six-weekly, in-between the wider review group’s meetings.

Minutes for each meeting will be taken by a member of the review secretariat team at the Scottish Government, who is providing secretariat support. 

Membership

Membership will reflect key stakeholders at the invitation of the Chair.

The subgroup is comprised of:

• Dr Robert Farley, Chair, NHS Education for Scotland
• Jo Vaughn, Chief Nursing Officer Directorate, Scottish Government 
• Sarah Smith, Chief Nursing Officer Directorate, Scottish Government, Healthcare Science Professional Advisor 
• Laura Turton, Audiology Adult Lead, NHS Tayside 
• Stephanie Doody, Interim Head – Audiology, NHS Forth Valley 
• Agnes Allen, Scottish Cochlear Implant Service Head, Consultant Clinical Scientist 
• Lizanne Steenkamp, Lecturer in Audiology, Queen Margaret University and Academy for Healthcare Science
• Elaine Gribben, Clinical Physiology Programme Lead, Glasgow Caledonian University
• Elisabeth Reynolds, Specialist Clinical Audiologist, Inverclyde (Queen Margaret University) 
• Alan Paterson, NHS Trainee Audiologist, Glasgow Caledonian University
• Nick McAlister, Head of Workforce Planning, NHS Lothian 
• Claire Benton, Head of Audiology, Consultant Clinical Scientist, Nottingham 
• Helen Martin, Ex Audiology Consultant Clinical Scientist, North of England Clinical Commissioning Support Unit, Durham 
• Amy Menzies, Clinical Scientist, Scottish Cochlear Implant Service
• Beverley Philip, Associate Practitioner, NHS Fife (Queen Margaret University) 
• Victoria Bienkowski Rodger, British Academy of Audiology Scotland; Ear Nose Throat and Greater Glasgow Clyde Paediatric Audiology; Scientist Training Programme Wales 

Representatives of Scottish Government policy teams for the Community Hearing Service and Healthcare Science Education may sit on this group as official observers.

Membership will be kept under review and the roles and responsibilities of the members will be set by the Chair.

Secretariat

The Scottish Government in its secretariat role to the Chair and subgroup will prepare meeting papers, and generally advise and provide support to enable groups to operate effectively. 

The Review benefited from a range of stakeholder contributions, for which there is a general acknowledgement in the Review Report. Aside from their representative input, individuals also directly contributed to the gathering and analysis of information from audiology services, those who access services and from those who work in audiology. Those leading the review gratefully acknowledge the work of those contributors. A list of those individuals who participated in the review group, sub-groups and reference group is provided below:

Members

Review Group

• Professor Jacqueline Taylor, Independent Chair
• John Day, Independent Vice Chair,
• Angela Bonomy, Chief Executive Officer, Sense Scotland
• Jim Harrigan, Head of Paediatric Audiology in NHS Greater Glasgow and Clyde
• Adrian Carragher, Head of Audiology, NHS Ayrshire and Arran
• Catriona Johnson, Associate Director for Managed Clinical Networks, Hearing Impairment Network for Children and Young People
• Susan Campbell, Clinical Lead, Universal Newborn Hearing Screening Programme Scotland
• Dr Robert Farley, Associate Director (Healthcare Science), NHS Education for Scotland
• Sandra McDougall, Deputy Director of Quality Assurance, Healthcare Improvement Scotland
• Lyn Hutchison, Senior Programme Manager for the Pregnancy and Newborn Screening Programmes, National Services Division, National Services Scotland
• Dr Andrew Murray, Medical Director of Forth Valley, NHS Board Chief Executives Group
• Kathryn Lewis, Head of Audiology (President of BAA), British Academy of Audiology
• Donna Corrigan, Chair, British Society of Audiology
• Dr Sam Lear, Senior Audiology Advisor, National Deaf Children’s Society Scotland
• Crystal Rolfe, Associate Director for Strategy – Health, Royal National Institute for Deaf People (RNID Scotland)
• Dr Shankar Rangan, Consultant of Paediatric Audio vestibular Medicine, The British Association of Paediatricians in Audiology Executive Committee (BAPA)

Reference Group

• Angela Bonomy (Chair), Chief Executive Officer, Sense Scotland, third sector/Scottish audiology sector  
• Rob Geaney, Team lead for campaigns and external affairs, Royal National Institute for Deaf People, third sector/lived experience
• Mark Ballard, Head of Policy and Influencing for Scotland, National Deaf Children’s Society, third sector/lived experience
• Dr Miles Mike, Chair of Scottish Academy, Scottish Academy, multidisciplinary
• Dr Brian Shannon, Educational Audiologist, Scottish Sensory Centre, teacher of the deaf workforce 
• Susan Campbell, Newborn Hearing Programme Clinical Lead, National Services Scotland, National Services Division, Clinical pathway/early intervention and prevention
• Jane Gallacher, SaLT CEN and SCIP, Scottish Cochlear Implant Service (SCIP), Clinical pathway/speech and language therapy workforce
• anonymous, service user, lived experience - adults
• anonymous, adult hearing aid user, lived experience - adults
• anonymous, parent, lived experience – paediatrics 

Quality Assurance subgroup

• Mr John Day, Clinical Director of Audiology (Chair), NHS Wales
• Sandra McDougall, Deputy Director of Quality Assurance, HealthCare Improvement Scotland (HIS)
• Dr Samantha Lear, Senior Audiology Advisor, National Deaf Children’s Society 
• Crystal Rolf, Associate Director for Strategy – Health, Royal National Institute for Deaf People 
• Susan Campbell, Clinical Lead, Newborn Hearing Screening Programme
• Kieran Joseph, The British Academy of Audiology (BAA)
• Donna Corrigan, Chair of BSA, The British Society of Audiology (BSA)
• Laura Turton, Adult Audiology Specialist, Scottish Heads of Audiology 
• Ruth Edgar, Paediatric Audiology Specialist, Scottish Heads of Audiology 
• Jane Gallagher, Speech and Language Therapist, Scottish Cochlear Implant Programme 

Structure, Governance and Leadership subgroup

• Adrian Carragher, Chair, Head of Audiology, NHS Ayrshire and Arran
• Jane Wild, Consultant Clinical Scientist and Head of Adult Audiology, Betsi Cadwaladr University Health Board (BCUHB), NHS Wales
• Kathryn Lewis, President, British Academy of Audiology
• Dr Brian Shannan, Service Manager of Deaf Children Service, NHS Fife, Teachers of the Deaf
• Arlene O’malley, Clinical Scientist, The Scottish Cochlear Implant Programme (SCIP)
• Dr Andrew Murray, Medical Director, NHS Forth Valley
• Mark Mitchell, Head of Service, NHS Grampian
• Crystal Rolfe, Associate Director, Health Programme Royal National Institute of the Deaf (RNID)
• Lyn Hutchison, National Services Scotland (NSS), National Specialist and Screening Services Directorate (NSD)

Education and Training subgroup

• Dr Robert Farley, Chair, NHS Education for Scotland
• Jo Vaughn, Chief Nursing Officer Directorate, Scottish Government 
• Sarah Smith, Chief Nursing Officer Directorate, Scottish Government, Healthcare Science Professional Advisor 
• Laura Turton, Audiology Adult Lead, NHS Tayside 
• Stephanie Doody, Interim Head – Audiology, NHS Forth Valley 
• Agnes Allen, Scottish Cochlear Implant Service Head, Consultant Clinical Scientist 
• Lizanne Steenkamp, Lecturer in Audiology, Queen Margaret University and Academy for Healthcare Science
• Elaine Gribben, Clinical Physiology Programme Lead, Glasgow Caledonian University
• Elisabeth Reynolds, Specialist Clinical Audiologist, Inverclyde (Queen Margaret University) 
• Alan Paterson, NHS Trainee Audiologist, Glasgow Caledonian University
• Nick McAlister, Head of Workforce Planning, NHS Lothian 
• Claire Benton, Head of Audiology, Consultant Clinical Scientist, Nottingham 
• Helen Martin, Ex Audiology Consultant Clinical Scientist, North of England Clinical Commissioning Support Unit, Durham 
• Amy Menzies, Clinical Scientist, Scottish Cochlear Implant Service
• Beverley Philip, Associate Practitioner, NHS Fife (Queen Margaret University) 
• Victoria Bienkowski Rodger, British Academy of Audiology Scotland; Ear Nose Throat and Greater Glasgow Clyde Paediatric Audiology; Scientist Training Programme Wales ​​​​