NHS Newborn Hearing Screening Programme

Marie Coughlin Screening Lead

May 24th 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 17th May & Sandra Smith starts 1st 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…

1212

1313

Aim of programme including mission statementAim of programme including mission statement

Quality standardsQuality standards

Newborn Hearing Screening care pathwaysNewborn Hearing Screening care pathways

Quality assuranceQuality assurance

Internal review and auditInternal review and audit

INTRODUCTION

14

INTRODUCTION

Risk managementRisk management

Cross boundary cooperation/Service level agreementsCross boundary cooperation/Service level agreements

Responsibility of the NHSP care programme centreResponsibility of the NHSP care programme centre

Reporting structuresReporting structures

Planning for the futurePlanning for the future

1515

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

18

1919

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

23

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!

2828

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 1st 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)

0

1

2

3

4

5

6

7

8 Target

National

SHA

Halton & St Helens

Knowsley

Liverpool

Sefton

Warrington

Western Cheshire

Wirral

Cent & East Cheshire

Screen Incomplete Rate – 2009/2010

0

1

2

3

4

5

6

7

8 Target

National

SHA

Halton & St Helens

Knowsley

Liverpool

Sefton

Warrington

Western Cheshire

Wirral

Cent & East Cheshire

Screen Complete by 4 Weeks after Birth – 2009/2010

80

90

100 Target

National

SHA

Halton & St Helens

Knowsley

Liverpool

Sefton

Warrington

Western Cheshire

Wirral

Cent & East Cheshire

Total Audiological Referrals from Programme – 2009/2010

0

1

2

3

4

5

6

7

8 Target

National

SHA

Halton & St Helens

Knowsley

Liverpool

Sefton

Warrington

Western Cheshire

Wirral

Cent & East Cheshire

Quality Assurance

Robust QA process in place managed by national programme centre

1st cycle of Peer Review QA visits completed

2nd cycle is underway

Highly effective eSP IT system used by local programmes

NHSP Trends performance monitoring tool

QA Site Reports 2008/2009Screen Audiology Medicine Early

Intervention - Education

Early Intervention-

Social

Mean QA

Score

Liverpool Well above average

Exceptional Well above average

Exceptional Well above average

4.23

Wirral Well above average

Satisfactory Satisfactory

Well above average

Gen below average

3.70

Chester Exceptional

Well above average

Well above average

Exceptional Well above average

4.16

Crewe Satisfactory

Satisfactory Well above average

Well above average

3.78

Warrington

satisfactory

Well above average

Gen below average

Satisfactory 3.74

Macclesfield

Exceptional

Well above average

Well above average

Exceptional 4.36

Sport, Formby, W Lancs

Well above average

Well above average

N/A Well above average

Satisfactory 4.07

St Helens & Knowsley

Exceptional

Above average/satisfactory

Well above average

Above average/satisfactory

Gen below average

3.98

Future Developments

3rd 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