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
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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
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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.
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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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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
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23
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CROSS BOUNDARY COOPERATION
Transferring babies out to other sites in optimum time scales
Regional meetings
Inclusion of other professionals
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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!
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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