National Audiology Review Group minutes: March 2023

Attendees and apologies

• Jackie Taylor (JT), Chair of Review
• John Day (JD), Vice Chair of Review and Betsi Cadwaladr University Health Board, North Wales
• Adrian Carragher (AC), Scottish Heads of Audiology Group (HoA)
• Robert Farley (RF), NHS Education for Scotland (NES)
• Angela Bonomy (AB), Sense Scotland
• Sam Lear (SL), National Deaf Children’s Society (NDCS)
• Susan Campbell (SC), Universal New-born Hearing Screening Programme
• Kathryn Lewis (KL), British Academy of Audiology (BAA)
• Lyn Hutchison (LH), National Specialist and Screening Services Directorate (NSS NSD)
• Jim Harrigan (JH), Scottish Heads of Audiology Group (HoA)
• Catriona Johnson (CJ), National Services Scotland, National Services Division (NSS NSD)
• Sandra McDougall (SM), Healthcare Improvement Scotland (HIS)
• Franki Oliver (FO) Royal National Institute for Deaf People (RNID)

Apologies

• Donna Corrigan (DC), British Society of Audiology (BSA)
• Crystal Rolfe (CR), Royal National Institute for Deaf People
• Andrew Murray (AM), Representative for NHS Boards Chief Executives
• Dr Shankar Rangan (SR), British Association of Paediatrician in Audiology (BAPA)
• Dr Shailaja Kottapalli (SK), British Association of Paediatrician in Audiology (BAPA)
• Agnes Allen (AA), Scottish Cochlear Implant Programme

Supported by

• Carole Campariol-Scott, Review Secretariat, Scottish Government
• Ian Roxburgh, Review Secretariat, Scottish Government
• Julie Townsend, Review Secretariat, Scottish Government
• Laura Sweeney, Review Secretariat, Scottish Government

Official observers

• Caroline Ballantyne, Scottish Government
• Claudine Duff, Scottish Government
• Raveena Sajjan, Scottish Government

Items and actions

Welcome, introductions and apologies

JT welcomed everyone to the meeting and noted the apologies.

Note and actions from previous meeting, published minutes

The minute of the previous meeting were agreed without amendment, and JT updated members on the actions from that meeting.

Update from the chair

JT confirmed that the British Academy of Audiology and the Health and Social Care Alliance Scotland engagement reports had been circulated and all the subgroups would hopefully have had the opportunity to digest them. 

RS updated members that communication had been issued to all NHS Boards following completion of the auditory brainstem response case sampling audit undertaken as a part of the Review and further engagement with NHS Boards was underway.

CCS confirmed the secretariat team is investigating issues with accessing Microsoft Teams channels and also exploring the possibility of using Microsoft SharePoint. The issues remained unresolved, but members could continue to use Objective Connect.

JD had attended the Cross Party Group on Deafness on 15 March 2023 where he gave an update on the Review, and although AB did not attend, she highlighted the feedback around the need for NHS Boards to be supported to make improvement. The point was made that effective implementation was essential to enable progress and change.

JT mentioned the need for an Oversight Group/Implementation Group, and RS advised of the need for Ministerial approval prior to publication of the Review report, and also the linkage with APS (print contractors) around publication and appropriate formatting and presentation. She added that no decisions will be made during Parliamentary recess i.e. 1 - 16 April 2023.

Comments on recommendations

Members considered whether the use of the phrases short medium or longer term should be used in the recommendations rather than defined timescales. RF felt that some indication of specific timescales would be helpful, outlining what short, medium and long term actually meant. JT asked if 3 months, 6 months and 1 year would be appropriate, but AC stated that the starting dates for taking action would also be important. JD noted that a lot would depend on the resources available to action the recommendations, and he felt that it would take approximately 2 years for the actions to be undertaken.

JT felt that the responsibility columns should reflect those who would be responsible for taking forward each recommendation, focussing on lead responsibility. She added that Heads of Service should be taken out and replaced with Health Board. (Responsibility, Accountability, Consulted and Inform (RACI)).

JD wondered about the need for an Implementation Group and felt that it would be advantageous and would be relevant to the discussion on ownership. AB proposed that some lines be included referring to the informal Heads of Service Group, and she noted that they would bear a lot of the responsibility for this work going forward.

Structure, governance and leadership subgroup

AC took members through his subgroup recommendations and the thinking behind them, beginning with those relating to Structure. JT proposed a recommendation for a Healthcare Science Lead at Director level at each Board be inserted, and AC agreed with that. RF referred to S3 noting that the other subgroups had made more or less the same recommendation. He stated that thought would need to be given as to how the recommendation is framed with possible reference to where the same recommendation appears across the subgroups.

AC felt on reading the recommendations that there was some overlap and duplication, and he agreed to look at the recommendations again to consider where they could be condensed. AB proposed that the first sentence in G1 be amended to read ‘external governance links’, and that was agreed. It was agreed that G4 would be slightly reworded to clarify what is meant by ‘benchmarking’. SL stated that G4 – G7 could be more clearly defined so that Heads of Service and Boards knew exactly what was required and be less open to interpretation, which JD agreed with.

AC agreed that G8 could be combined with G1, with work also to consider whether G10 should be combined with the Workforce recommendation. AB said that G10 cannot be specific  to audiology, so she wondered if other services could be referred to in terms of work done in their specialities. CJ asked if services need to be provided at each Board, and JT replied that that might be a topic to be considered at the Implementation stage.

AC noted that G12 was a duplication so would be looked at for consolidation with an earlier recommendation, and JT felt that both G13 & G14 were covered by the overarching recommendation for the National Audiology Advisory Group.

G15 would be edited to remove the reference to Healthcare Improvement Scotland. SL asked about governance within local services which she felt was not covered in the governance recommendations and she said that she would send AC suggested wording.

JT noted the likelihood of overlap between the Leadership recommendations and those from RF’s group. AB referred to L2 stating that there should be a reference to customer service, and JD added that reference should be made to the Higher Specialist Register for Healthcare Science, perhaps in a separate recommendation.

RF advised that the Register had not gained traction in Scotland, but JT felt that such a recommendation should be made in any case. SL added that equivalence should also be considered, and it was agreed that JD & AC would work on the wording of the recommendation.

It was noted that L4 & L5 were also covered under Education recommendation 26. RF suggested leaving the recommendations as they are, but with cross reference where there is duplication; JT said that she liked that idea.

Quality assurance subgroup

JD then took members through his subgroup recommendations.

AB asked about ensuring that quality standards include all the policy levers across the landscape, giving Getting it Right for Every Child (GIRFEC) as an example.

Education and training subgroup

RF went through his subgroup recommendations, noting there would appear to be duplication, but that it would be important to outline the context in which they were produced.

JT noted that the reference to officers who will be responsible may need to be amended to read Scottish Government, as the posts are being recommended but don’t exist at present.

JD asked about including a reference to the promotion of gaining Masters level knowledge, and RF said that he could add a coda to refer to JD’s suggestion. JD also referred to the skills sought at the point of recruitment, and AC proposed that that could be linked to development of job descriptions and the oversight of recruitment. JD added that a reference to quality and quality assurance be included in standardised job descriptions.

Overarching recommendations

AB advised that she would draft a page for inclusion in the report on the key themes, of which she had a list.

JT stated that the reference to the Audiology Specialist Group should be amended to Audiologist Advisory Group, and there also needed to be a reference to the creation of an Implementation Group. Strategic planning needs also should be included. RS queried the Review’s views on membership for these respective groups and JT advised RS that she could come back to her with detail on what the membership of the Advisory group should look like. JD believed that the Advisory Group should be badged as a Scottish Government Group, whilst the Heads of Service Group should be more operational, with discussions on topics that they would want raised at the Advisory Group.

CJ stressed the importance of understanding of what existing structures are in place, and how the Advisory Group would connect with them. SL envisaged that the Advisory Group would have direct lines of communication to the Scottish Government, and JD informed members that a similar structure had been in operation in NHS Wales. He added that the Advisory Group should have policy and professional membership from the Scottish Government.

FO wondered if subjects that were out of scope of the review should be mentioned in the report and recommended for further exploration.

Next steps

Members heard that work would begin on the consolidation and cross referencing of the recommendations and adding the contribution from AB to the draft report. JT confirmed that the intention would be following the completion of that work to recirculate the draft report and recommendations for electronic final sign off.

AB noted that the Reference Group had an expectation that they would see a final version of the recommendations before they were published, and JT agreed that they would have sight of them before the report is submitted which she hoped would be by 31 March 2023. JD wondered if the morale of audiologists should be monitored going forward.

JT undertook to keep members informed of developments following submission of the report, though she did not envisage the need for another meeting of the group. She then thanked members for all of their work on the Review.