NHS Newborn Hearing Screening Programme Marie Coughlin Screening Lead May 24 th 2010

Today’s Session Third of 6 Antenatal & Newborn sessions throughout 2010

Reasons for Today’s Session As a result of ChaMPs commissioned review of screening A need to further engage public health in Antenatal & Newborn Screening Programmes At the request of public health screening leads Part of C&M Screening Action Plan Thought it useful to invite commissioners also

Aim of the Session To increase knowledge base within public health and commissioning

Session Format Overview of UK NSC/NWSHA structure Overview of Newborn Hearing Screening Review of patient pathway Data, performance and QA Future developments Questions/comments

Overarching Structure UK NSC oversees 6 Antenatal & Newborn Screening Programmes UK NSC has defined accountability & governance structure for SHA, PCT and provider National Programme Centre oversees QA function NWSHA coordinators now recruited; Rebecca Till started 17 th May & Sandra Smith starts 1 st July

Newborn Hearing Screening Full roll-out of Programme across England by 2006 Recognised as one of world leaders in Newborn Hearing Screening Has one of the best clinical IT systems in NHS Patient choice more important than uptake rates To ensure equality of access & reduction of health inequalities

Programme Aims To offer informed choice To offer quality screening to the parents of 99% of babies born To identify all children born with moderate to profound permanent bilateral deafness within 4-5 weeks of birth Babies referred from Programme should receive full audiological assessment within 4 weeks of screen To promote and develop family friendly integrated services which support effective early intervention for deaf children

Newborn Hearing Impairments Explained On average every week in England — 12,500 babies are screened — 270 (2%) babies are referred for audiological assessment — 15 babies identified with a permanent childhood hearing impairment

Patient Pathway…

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13 Aim of programme including mission statement Aim of programme including mission statement Quality standards Quality standards Newborn Hearing Screening care pathways Newborn Hearing Screening care pathways Quality assurance Quality assurance Internal review and audit Internal review and audit INTRODUCTION

14 INTRODUCTION Risk management Risk management Cross boundary cooperation/Service level agreements Cross boundary cooperation/Service level agreements Responsibility of the NHSP care programme centre Responsibility of the NHSP care programme centre Reporting structures Reporting structures Planning for the future Planning for the future

15 AIM Within the context of the Newborn Hearing Screening Programme the aim is to ensure that the whole screening pathway including associated follow on services is functional and safe.

16 MISSION STATEMENT High quality Early identification Family friendliness Parental empowerment Quality assurance which encompasses quality standards

17 QUALITY STANDARDS Newborn Hearing Screening Sites are externally assessed via fourteen quality standards which have to be reached

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20 RISK MANAGEMENT Prevention of mistakes Management of risk Recording discrepancies Putting mechanisms in place to reduce mistakes

21 Risk management Parental satisfaction survey Screening coverage Audiology referrals Auditing Safe and functional IT systems

Information systems 22

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24 CROSS BOUNDARY COOPERATION Transferring babies out to other sites in optimum time scales Regional meetings Inclusion of other professionals

25 WHAT ARE THE RESPONSIBILITIES OF THE NHSP CARE PROGRAMME CENTRE? Support Guidance Risk management Ensuring that qualities are maintained over country

26 REPORTING MECHANISMS Regular reports NHSP trends End of second cycle of QA visits, What now?

27 FUTURE PLANNING Originally 122 sites now 116 Screening coverage Sites working together Lets make sure that we put our families first!

28 ANY QUESTIONS

Data & Performance Trusts required to produce annual report – difficult to obtain copies NHSP produce annual report 2008/2009 annual report in brief: — Screening Equipment Data Quality (SEDQ) project led to successful equipment upgrade and replacements — Completed 1 st round of Peer Review QA visits across England — Implementation of NHSP Trends performance reporting tool — Major improvements need to be made to ensure that screening coverage, audiological assessments, social care support and involvement of families of deaf children in the development of services across England, meets the quality standards

Screen Decline Rate – 2009/2010 (Trends)

Screen Incomplete Rate – 2009/2010

Screen Complete by 4 Weeks after Birth – 2009/2010

Total Audiological Referrals from Programme – 2009/2010

Quality Assurance Robust QA process in place managed by national programme centre 1 st cycle of Peer Review QA visits completed 2 nd cycle is underway Highly effective eSP IT system used by local programmes NHSP Trends performance monitoring tool

QA Site Reports 2008/2009 ScreenAudiologyMedicineEarly Intervention - Education Early Intervention- Social Mean QA Score LiverpoolWell above average ExceptionalWell above average ExceptionalWell above average 4.23 WirralWell above average Satisfactory Well above average Gen below average 3.70 ChesterExceptiona l Well above average ExceptionalWell above average 4.16 CreweSatisfactor y Well above average 3.78 Warringto n satisfactor y Well above average Gen below average Satisfactory3.74 Macclesfi eld Exceptiona l Well above average Exceptional4.36 Sport, Formby, W Lancs Well above average N/AWell above average Satisfactory4.07 St Helens & Knowsley Exceptiona l Above average/sati sfactory Well above average Above average/satisfa ctory Gen below average 3.98

Future Developments 3 rd cycle of Peer Review QA visits eSP improvements to include new audiology pages and new appointments system Replace Echocheck screening equipment at community sites by 2010 Replace Echoport screening equipment in hospitals by 2011

Questions/Comments With regard to QA, how do we assure our Boards that local programmes run satisfactorily? Develop set of recommendations for DsPH re lack of screening data from local programmes (for all antenatal & newborn programmes)

Thank You