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 both Adult and Paediatric 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 " NHS Quality Improvement Scotland ( QIS) 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 fulfill 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 work covered Adult Hearing Rehabilitation Services.
Around the same time, a multidisciplinary group of professionals working in Paediatric Audiology from England, Scotland and Wales, under the guidance of MRC Hearing and Communication Group, began developing draft quality standards and an accompanying quality rating tool for Paediatric Audiology, also using the NHSQIS methodology. This final document evolved from that original work.
A 6 Paediatric site audit of the modernisation process was carried out by Davis et al 2007, with support from the late Professor Stuart Gatehouse, which used the draft standards to assess services against. In taking that task forward the audit group developed a Quality Rating Tool ( QRT) which 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 draft standards and QRT have been updated in the light of their use, together with comments from stakeholders.
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