Impact of Newborn Hearing Screening Programme on Paediatric Audiology Services in England Kai Uus MD PhD NHSP Evaluation Team University of Manchester United Kingdom

Newborn Hearing Screening Programme in England  NHSP started on 1 st 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 1 st phase of NHSP (23 areas)  More information on NHSP:

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: 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)

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= , 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

Expected Challenges: 1. Shortage of staff 2. Lack of skills/knowledge 3. Resource problems 4. Lack of facilities 5. Organisational barriers 6. Inadequate links with other services 7. 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 Uus NHSP Evaluation Human Communication & Deafness Group The University of Manchester Oxford Road Manchester M13 9PL Phone: +44 (0) Fax: +44 (0)

THANK YOU!