Independent Review of Audiology Services in Scotland

Purpose and scope of the Review

The purpose of the National Review was to establish the current level of assurance within existing audiology services; to assess this within the scope of the Review; and to make recommendations to improve the assurance of audiology services within NHS Scotland. The full Terms of Reference of the Review can be found on the Review webpage (1).

The remit of the Review Group was to:

• review the current structure, governance and leadership of paediatric and adult audiology services;
• provide a quality assurance appraisal of services, surveying key elements of existing service provision, with a particular focus on issues impacting on patient outcomes;
• review existing quality assurance arrangements, making recommendations necessary to establish robust quality assurance processes, and to effect improvements in service quality, and outcomes for patients on a permanent basis;
• review current education and training and CPD provision;
• understand the lived experience of people living with hearing loss and their carers and families.

It was important that the Review took a pragmatic approach, made best use of current information and resources, avoided duplication of other workstreams and was mindful of ongoing work in this area including:

• the See Hear Strategy currently being taken forward by the Scottish Government;
• the Universal Newborn Hearing Screening (UNHS) programme;
• work undertaken by the Scottish Heads of Audiology Group, the Hearing Impairment Network for Children and Young People (HINCYP) and Diagnostics in Scotland Strategic Group (DiSSG) in consideration of any identified opportunities for improving audiology services;
• use of established and evidenced-based Quality Standards for Adult Rehabilitative Audiology and Paediatric Audiology Services;
• the Scottish Government Healthcare Science Education and Workforce Review and forthcoming Healthcare Science Strategy;
• recommendations proposed by the National Deaf Children’s Society (NDCS) and any work undertaken by wider partners.

While the Review Group was well aware of the issues affecting audiology care in NHS Lothian and elsewhere, it also recognised that there is evidence of high quality in audiology services in Scotland, where service-user needs are identified and addressed in a timely, efficient and compassionate manner.

This is reflected in some of the comments from parents quoted in the ALLIANCE report (2).

Here are some examples:

“The staff were fantastic. Understandably my husband and I were in shock and very upset. The staff were so supportive and reassuring that my son would get all the help he needs to thrive…The audiologists are so caring and have really taken the time to get to know my son and his hearing loss.”

“We have always, as a family, been fully supported and everyone involved in service provision has been outstanding. Overall, the quality of service has made a profoundly positive difference to our child’s life.”

By contrast, other parents had a far less positive experience and their comments indicate the scale of the challenges ahead:

“I am more concerned about the two-year waiting times for children who are clearly deaf but have to wait to be assessed while their crucial opportunities for language development and perhaps even cochlear implants are missed.”

“Given the length of time it took for my daughter to be diagnosed, I would imagine they are very much under pressure and in need of more staff.”