National Audiology Review Group minutes: September 2022

Attendees and apologies

• Robert Farley, NES
• Jim Harrigan, Heads of Audiology
• Donna Corrigan, BSA
• Sandra McDougall, HIS
• Susan Campbell, NBHS
• Kathryn Lewis, BAA
• Shailaja Kottapalli, BAPA
• John Day, Clinical Director of Audiology, Betsi Cadwaladr University Health Board, North Wales
• Angela Bonomy, Sense Scotland
• Catherine Ross, Scottish Government
• Crystal Rolfe, RNID
• David Comiskey, Heads of Audiology
• Lyn Hutchison, NSD
• Rachael Dunk, Scottish Government
• Samantha Lear, NDCS

Supported by

• Abigail Parkin, Review Secretariat - Scottish Government
• Carole Campariol-Scott, Review Secretariat - Scottish Government

Official observers

• Julie Townsend, Scottish Government

Items and actions

Welcome and introductions

The chair welcomed all members and introduced Julie Townsend who will be joining the review secretariat team as of 23 September, at which point Abigail Parkin will be leaving the review secretariat team. The chair also introduced a new member of the group, Dr Kottapalli, a Consultant in Paediatric Audio vestibular Medicine at Mid-Cheshire Hospitals NHS Foundation Trust, and a member of the BAPA Executive Committee.

The chair is aware that the Scottish Cochlear Implant Programme (SCIP) have requested representation on the review group and that a request will be made to SCIP from the review secretariat to that effect this week.

Note of previous meeting, published minutes and terms of reference and meetings administration

The notes of meeting 1 are available on the review webpage. The notes of meeting 2 are in the process of being published. The note of meeting 3 were published by error and will be removed from the website to allow the group to review. The terms of reference have been updated to reflect membership from BAPA and are available on the Scottish Government website.

Action secretariat: to remove the note of the last meeting 3, which has been published on the website and circulate for comment. Circulate the conflict-of-interest paper for information.

Action Shailaja Kottapalli: to complete a declaration of interest form.

Note (amendment) – subsequent to August’s (review group meeting 3) meeting, there was an error in John Day’s job title. John Day’s correct title is Clinical Director of Audiology, Betsi Cadwaladr University Health Board, North Wales

The chair discussed the membership of the group and widening engagement with audiologists. Kathryn Lewis suggested the BAA could run workshops to gauge a wider view and gather common themes. It was also acknowledged that the reference group is engaging with service users.

Adrian Carragher asked about numbers of audiologists and the need to explore the wider community, as not all will members of BAA in Scotland (David Comiskey agreed membership is more limited in Scotland). Sam Lear at BAA is happy to host workshops with meaningful themes. John Day confirmed that a question-and-answer session would be very helpful around such as quality of services and development. Rob Farley and Angela Bonomy agreed. Angela Bonomy agreed this is in line with the reference group, following the patient pathway and the interconnections.

Action: Sam Lear and Kathryn Lewis: to contact the review secretariat about running workshops to engage with wider Audiologist community.

Update from chair

The chair updated the group on the use of a Power Point slide deck for all meetings going forward in order to help structure the meetings and give a standardised approach. Subgroup chairs should also use the same format for their meetings going forward. The review secretariat will share the template and create a slide deck for upcoming reference group and subgroup meetings.

The chair told the group she had an interim reporting meeting scheduled with the Cabinet Secretary for 1 November. The chair added that the visual timeline of milestones for the review is now available in all Objective Connect folders. Members are asked to consider the feasibility of the timescales at this stage of the review process. The chair highlighted some of the milestones, such as the public engagement to be managed by the reference group, a draft report in December 2022 and a final report scheduled for February 2023, although further flexibility may be required.

The chair advised she will attend one meeting of each of the subgroups in the near future.

The chair was due to attend the Cross-Party Group (CPG) on Deafness on 14 September, however, this was cancelled due to the passing of the Queen. The review secretariat will arrange a pre-meeting with CPG secretariat and the chair ahead of the next CPG meeting which is scheduled for 7 December.

The chair did confirm that she had a very helpful meeting with SCIP around input to the review and they are keen to contribute. The chair emphasised how important it is that Audiology services link with both education and speech and language therapy services and that this must be captured by the Review.

Reference group and subgroups updates

Reference Group

Angela Bonomy, reference group chair confirmed that the first meeting was held on 18 August 2022 and there was broad agreement around representation and approach. Timescales were discussed and also the importance of timely and meaningful input from the reference group and subgroups to the review Group. It was agreed that there are areas of intersection. The second meeting for the reference group was scheduled for 12 September but is now being rescheduled to the week commencing 19 September. This meeting will be used to define questions for the engagement exercise to be undertaken by the ALLIANCE. The exercise will adopt a set of questions that can be applied to different scenarios. This will allow a consistent approach, irrespective of the size of the various engagement events.

The chair and subgroup chairs will meet on 27 September to discuss how the subgroups can meaningfully engage and feed back into the review.

Action secretariat: finalise date and time for the second meeting of the reference group. 

Structure, leadership and governance subgroup

Adrian Carragher, subgroup chair told the group that Meeting 1 is scheduled for Wednesday 21 September, and that he had been engaging with other subgroup chairs to recognise commonality between the groups. Adrian Carragher will provide an update report.

Action Crystal Rolfe: RNID to name a representative to sit on the structure, governance and leadership subgroup ahead of next week’s meeting.

Quality assurance subgroup

John Day, subgroup chair for quality assurance told the group meeting 2 was held on 6 September. The group had a discussion around draft Knowledge Performance Indicators (KPI’s) and agreed KPI’s needed to be meaningful, provide reassurance and be achievable within the timescale and resources of the group. John Day presented his Highlights report to the group and confirmed the subgroup was currently on track with its work. Healthcare Improvement Scotland (HIS) provided a presentation on their work on quality assurance and the role of HIS and quality assurance systems which could be developed and implemented in Scotland. John Day also presented a very useful Intersections document which can be updated to include the reference group.

The subgroup is keen to engage with the Health Boards’ Heads of Service and John Day is arranging to meet with them in due course.

Action John Day: to engage further with the Health Boards’ Heads of Service to feed into the work of the group. John Day to amend the Intersections Paper and share with all the groups.

Education and training subgroup

Rob Farley, the Education and training subgroup chair, confirmed that meeting 2 was held on 7 September when the group examined the Lothian report themes around education and training and what the group should take forward. Again, it was highlighted that there are areas of intersection between the groups. Rob Farley presented his Highlights report to the group. The subgroup has been looking at the following four draft recommendations: 1) training officer in every department; 2/establish a core training register; 3/ annual appraisals and 4/an accountable scientific lead to oversee external core training registers.

Crystal Rolfe added that it was good to see draft recommendations being shaped and that RNID would like to take part in conversations around the shape of training provision in the context of new technology and how this could impact on the format of current training provision. This could include looking at best practice, which in turn could feed into the work of the Quality assurance subgroup.

Angela Bonomy added that the above four recommendations were linked to structure and governance. Lyn Hutchison added that training providers needed to have the numbers to run courses. Catherine Ross highlighted that a wider review of education and training for Healthcare Scientists is currently ongoing, which the subgroup should be mindful of and would need to consider if its recommendations aligned with that review.

The subgroup chair reinforced the major concerns about workforce shortages in audiology and indicated the challenging timescales for HEI’s if they were required to develop or restart a course. While the wider review of training and education of healthcare scientists may recommend a variety of routes into audiology, a short term “fix” or bridge may well be necessary. The public engagement exercise the reference group will run will provide views on what is happening now by the people on the ground. John Day added that workforce shortages will impact on quality and safety of service.

Action: the subgroup will explore the above four recommendations further and how they can be linked into the Intersections paper.

Action: it was suggested that the urgent need for training in Scotland should be raised at the meeting with the Cabinet Secretary on 1 November while acknowledging that a wider education and workforce review of Healthcare Science is ongoing. The chair advised that this would be discussed at her meeting with the group chairs and an appropriate recommendation would be made at her meeting with the Cabinet Secretary.

Any other business and date of next meeting

Shailaja Kottapalli asked the group for more information in order to understand the patient pathways of referral in Scotland. John Day confirmed that this was one of the KPI’s and that he will share it with Shailaja Kottapalli for comment.

The timeline was discussed further and there is recognition that some factors may impact on the Review’s availability to deliver. Adrian Carragher added that it would be helpful to think about quick actions which the Review could act upon and provide Heads of Service with reassurance on expectations. Adrian Carragher agreed to manage the communications with Heads of Service. The chair confirmed that this can be conveyed to the Cabinet Secretary on 1 November.