impact of newborn hearing screening programme on paediatric audiology services in england kai uus md...
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Impact of Newborn Hearing Screening Programme on
Paediatric Audiology Services in
England Kai Uus MD PhD
NHSP Evaluation TeamUniversity of Manchester
United Kingdom
Newborn Hearing Screening Programme in England
NHSP started on 1st December 2002
The plan is to cover 100% of England (600,000 births pa) by end March 2005
Department of Health funds the Evaluation of the 1st phase of NHSP (23 areas)
More information on NHSP: www.NHSP.info
NHSP Evaluation Team: John Bamford University of Manchester
Rachel Crocket (Holly Baker) King’s College London
Theresa Marteau King’s College London
Wendy McCracken University of Manchester
David Parker University of Manchester
Helen Tattersall University of Manchester
Rod Taylor University of Birmingham
Alys Young University of Manchester
Aims & Objectives:
To explore and quantify impact of Newborn Hearing Screening Programme (NHSP) on Paediatric Audiology services
Material & Methods:
Questionnaires sent to Heads of the Paediatric Audiology Services (N=23)
Follow-up telephone interviews with Heads of the Paediatric Audiology Services (ca 30 min)
Repeat questionnaires and interviews ca 1 year into the programme
Readiness for NHSP:
30%
60%
10%
Extremely well
Quite well
A little
How well do you think your Service is prepared for NHSP?
A year later, how well do you think your Service was prepared for NHSP?
Routine procedures (pre- and post-implementation)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
BC ABR Tone-pipABR
HF tymp PTM DSL/NAL
Pre-impl
Post-impl
Readiness vs routine procedures:
No correlation between self-perceived readiness and routine tests/procedures:– Tone-pip ABR: (Mann-Whitney U=18.5, Z=-1.938, p=0.053)
– BC ABR: (Mann-Whitney U=20.5, Z=-1.446, p=0.148)
– High-frequency tympanometry: (Mann-Whitney U=28.5, Z=-0.730, p=0.465)
– DSL, NAL or other published hearing aid prescription procedure : (Mann-Whitney U=20.0, Z=-1.213, p=0.225)
– Probe-tone measures: (Mann-Whitney U=28.5, Z=-0.730, p=0.465)
Satisfaction with Links(pre- and post-implementation)
Sign Test: p=0.000
0%
10%
20%
30%
40%
50%
60%
70%
Very satisfied Quite satisfied A little satisfied Not at all satisfied
Education
Education 1
Social Services
Social Services 1
Expected Challenges:
1. Shortage of staff 2. Lack of skills/knowledge3. Resource problems4. Lack of facilities5. Organisational barriers6. Inadequate links with other services7. Management attitude
Expected Opportunities:
1. Better opportunities for children and families
2. Raising the profile 3. New skill development 4. Increased resources 5. Better links with other services
Major training needs:
Working with very young babies– handling babies– child development
Advanced diagnostic assessment– SSEP – BC ABR– tone-pip ABR– aetiological investigation
Major training needs (cont):
(Re)habilitation– Current HA technology– Probe tone measurements– Practical aspects (earmoulds)– Assessing the subjective benefit of the
intervention
Support parents– Counselling and breaking bad news– Dealing with anxious parents
Training: Centrally funded training Supervised, practical, hands-on Quality control, standards, accreditation
Affordable Easy access Good information on courses MORE TRAINING OPPORTUNITIES
Who will meet the training needs?
In-service training, peer training Networking Visits to the clinical centres of
excellence Manufacturers, suppliers etc. NDSC Universities Local, regional and national
Conclusions:
Great variety in–current practices –expectations–links with other services
Training is urgently needed
Acknowledgements:
This work was undertaken by the Evaluation Team for the Implementation Pilot of Newborn Hearing Screening which received funding from the Department of Health. The views expressed in the publication are those of the authors and not necessarily those of the Department of Health
Contact:
Dr Kai UusNHSP Evaluation
Human Communication & Deafness GroupThe University of ManchesterOxford RoadManchester M13 9PL
Phone: +44 (0) 161 275 8282Fax: +44 (0) 161 275 3373E-mail: [email protected]
THANK YOU!