Quality Standards for Adult Hearing Rehabilitation Services

4. Development of the Quality Standards

In July 2006, a project working group was established with a remit to develop a set of national standards to accompany a self-assessment framework for hearing aid services in adults. The group, chaired by Martin Evans, comprises a variety of healthcare professionals involved in the delivery of audiology services, patient representatives and representatives from the voluntary sector, higher education, the UK health departments, senior NHS management and the private sector. The group's full membership can be found in Appendix 1.

The group worked in a number of facilitated sessions to identify key critical areas for clinical standards that were unique to audiology (other areas such as workforce development, efficiency, innovation and patient experience were outside the scope as they are covered by more generic NHS standards). The group identified six standards that followed the service user journey and three areas of infrastructure that were unique to audiology services. These were

• Referral pathways
• Information Provision and Communication with Individual Patients
• Assessment
• Developing an individual management plan
• Delivering an individual management plan
• Outcome
• Professional competence
• Multi-Agency Working
• Service Effectiveness and Improvement

The approach taken to develop the standards described in this document involved considering a broad range of service quality issues that share the common feature of ultimately impacting on health outcomes for service users. In an environment where the allocation of health service resources may be driven by access time targets it is particularly important to encourage recognition of other worthy (and ideally measurable) service quality issues. These standards have, therefore, been developed and constructed bearing in mind the need for an associated questionnaire-based tool to assess performance of services against the standards. The approach taken in the more detailed development of the standards was to follow the service user pathway to describe the key service quality themes. Standards 1-6 describe the service user journey and care pathway, whilst 7-9 relate to professional delivery and communication mechanisms that underpin the other standards. Whist Audiology services have benefited from significant technological advances in recent years, achieving beneficial outcomes for service users is also heavily reliant on non-technological, holistic and customized approaches to intervention that are all reflected in the standards. In particular, the development of care tailored to the best needs of the individual is reflected by the adoption of the Individual Management Plan ( IMP) as a prominent feature ( See Appendix 4).

The group agreed that, following the production of draft standards, there should be a full consultation with service users and their carers/families, referrers and professionals delivering hearing aid services. The information collected during consultation was used to inform the content of the final standards.

4.1 Context

These standards are designed to improve service quality issues in clinical areas unique to Audiology within the NHS: elements of service quality such as cleanliness of facilities or workforce development are outside of the scope of this work as they are expected to be addressed by local healthcare governance mechanisms and/or more generic NHS standards.

Although the standards apply to NHS audiology, the hope is that their implementation will encourage and further develop collaborative working, both with fellow NHS professionals and external agencies.

In addition, awareness of and compliance with statutory requirements, such as the Disability Discrimination Act 2005, is assumed, as is awareness and understanding of consent requirements.

It would be impossible to exhaustively list the many and varied service user groups who access adult hearing rehabilitation services, therefore, it is intended that these standards apply to all service users equally.

4.2 Evidence Base

During the development of the draft quality standards for adult hearing aid services the project group considered a wide range of documents from a variety of sources and these are fully referenced in Appendix 2.