In January 2003, the Public Health Institute of Scotland ( PHIS) published a Needs Assessment Report on NHS Audiology Services in Scotland. This report identified a number of areas in which Audiology services were failing to meet the standards expected by service users and other stakeholders. The modernisation of hearing aid services tried to address these areas as well as modernise the patient journey.
Scotland began the modernisation of its audiology services in 2003 by investing in new Digital Signal Processing ( DSP) hearing aid technology, new infrastructure, information systems and training based around the patient care pathway. However, whilst there was clarity around the patient pathway there was no clarity around appropriate quality standards by which the services could be audited or on which services could base a service improvement plan.
One of the recommendations of the PHIS Report was that " NHSQIS would produce an agreed set of standards for audiology services and conduct an assessment of the service's ability to meet these standards, taking into account established documents from voluntary bodies and professional organisations." In its response to this recommendation, NHSQIS indicated that it would not be possible to fulfil this within a timescale that all interested parties could agree to.
It was then suggested that the work be undertaken by a sub-group of the Scottish Government's Audiology Services Advisory Group following the NHSQIS standards development methodology and that NHSQIS would consequently quality assure the development process.
This document has subsequently been developed by a multi-disciplinary project group comprising representatives from the Audiology profession, the voluntary sector, higher education, UK health departments, senior NHS management and others.
An audit of that modernisation process has been carried out by Davis et al 2007, which used a set of draft standards, with support from the late Professor Stuart Gatehouse, against which services could be viewed for this purpose. In taking that task forward the audit group developed a Quality Rating Tool that attempted to directly assess services against those draft standards to establish whether the services
- are responsive to their needs
- empower patients to be good partners in meeting those needs
- make the best use of staff skills and resources.
The timescale of the audit meant that it had to use draft standards which have been updated in the light of their use, together with the quality rating tool.
Comments from stakeholders have been elicited about the standards, rationale and criteria for the adult hearing services quality standards, together with the quality rating tool.