AUDIOLOGY AND ENT
Improving audiology services
NHS Improvement’s director of audiology improvement Fiona Thow considers the way to improve audiology services throughout the NHS.
NHS
Improvement’s strength and expertise lies in practical
service improvement. It has over a decade of experience in redesigning clinical pathways in cancer, diagnostics, heart, lung, stroke and audiology services, which have helped to improve patient experience and outcomes at over 250 sites across England.
It has worked in partnership with the Department of Health National Audiology Programme since July 2008, supporting services. In assisting 12 challenged sites to reduce waiting times and subsequently supporting 18 sites to improve the quality of patient experience, it identified and tested four winning principles:
• Direct access • One-stop clinics • Care closer to home – community services
• Developing protocols for patients with complex hearing problems.
48 | national health executive Mar/Apr 12
Six out of the 18 pilot sites went onto a prototype phase to test these principles further. Emerging learning was shared via strategic health authority clinical lead networks, presentations and workshops including to the British Academy of Audiologists and also via an audiology e-bulletin. Strong partnerships were also forged with third sector partners, including the National Deaf Children’s Society, Action on Hearing Loss and British Tinnitus Society Association, to support and input into the improvement work.
The hospitals involved have continued to develop their services and pathways with larger numbers of patients, using their input to shape future developments. Commending the work, the Department of Health’s chief scientific officer Professor Sue Hill said: “These pilot sites, working with NHS Improvement have applied Lean principles to demonstrate how improvements can be made across the pathway that will change the way audiology
services should be delivered in the future.”
During the project, it was demonstrated that service improvements could be made in a variety of settings.
Nottingham University Hospitals NHS Trust wanted to re-design the support provided for patients who routinely required access to hearing aid assessments and simple repairs. The new pathway aimed to be more efficient and cost effective and also, importantly, offer patients care closer to home, therefore improving accessibility, whilst maintaining or improving quality. Accepting that an ageing population will inevitably lead to an increase in demand, it was also agreed to test how a well trained workforce would provide services in future. A further aim was around providing evidence that the service could be delivered safely and effectively using the support of associate practitioners. This was tested and measured by comparing clinical and patient outcomes between existing
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