The Scottish Government has today (25 August 2023) published the final report and recommendations of The Independent National Audiology Review.
Here, Associate Director for Health at RNID, Crystal Rolfe, explains what the Review has been about, why it happened, what it said and how RNID will work to ensure its recommendations improve vital audiology services across Scotland.
What was the Audiology Review?
In January 2022 the Scottish Government established an Independent National Audiology Review to examine the way in which audiology services are provided across the 14 Health Boards which provide NHS services across Scotland.
The Review was commissioned by the then Cabinet Secretary for Health, Humza Yousef MSP. The purpose of the Review was to examine audiology services by health boards across Scotland, and for them to make recommendations on how the services can be improved.
The remit of the Review was to:
- review the current structure, governance and leadership of audiology services across Scotland;
- provide a consistent appraisal of services, with a particular focus on issues impacting on patient outcomes.
- review the current education and training provided to audiologists and the further training they get throughout their careers.
- understand the lived experience of people living with hearing loss and their carers and families.
Why did the Scottish Government launch the Audiology Review?
The primary reason the Review was established was the discovery of failings in the provision of services to children by one Health Board, NHS Lothian. In this area a review by the British Academy of Audiology (BAA) uncovered significant failure in the care of 155 children.
In addition, the Review was established to explore the multiple, systemic problems within adult audiology services in NHS Scotland. There are a number of issues within Scottish audiology services, including a shortage of trained health care professionals and a failure to track the outcomes of patients who use audiology services.
What was RNID’s involvement?
As RNID’s Associate Director for Health and a former practicing audiologist I represented the charity on the Review, sitting on the main body which agreed the findings and created the Review’s recommendations. Other members of RNID’s Policy and Campaigns Team also sat on the working groups which conducted the review.
We worked to ensure the needs of patients were accurately captured in the review.
Throughout the Review our key focus was representing the needs of our communities, highlighting the barriers that people face when accessing audiology services and demonstrating where people who are deaf or have a hearing loss feel that they are being let down.
What does the review say about audiology services in Scotland?
The Review highlighted existing evidence showing that hearing loss, especially when undiagnosed and treated, can have an enormous impact on people’s quality of life, affecting work, relationships, social isolation and presenting an increased risk of other conditions, such as depression and dementia. But the review also highlights the positive impact that audiology services can have – demonstrating why they are so important for the 1 million people across Scotland living with hearing loss.
The Review also presented a number of concerns with the way audiology services are provided across Scotland. This included concerns about the number of trained audiologists, the way services record the quality of the service they provide to patients and the leadership that each Health Board gives to its audiology services.
Worryingly, the Review also presented evidence that audiology lacks profile, and that the professionals working in the system feel like their services are seen as less important than other specialisms within the Scottish NHS. The report notes, ‘coming at a time when NHS Scotland is facing unprecedented and unrelenting pressures, audiology must compete with other sectors for finite funding and resources’.
What did it recommend? What do we think of these recommendations?
The report made 55 recommendations to the Scottish Government, covering oversight of audiology services, governance, leadership, Quality Standards, and Education & Training. We welcome these recommendations and think they set out a credible plan for better, more consistent audiology services across Scotland.
We are particularly keen that the Review is used as a catalyst to raise the profile of audiology and therefore want to see the Scottish Government take up the recommendation to designate a policy lead for audiology. We hope this accountability can be an important mechanism to drive up standards.
The Review also recommended the establishment of two further groups: an implementation group which will lead on delivering the recommendations of the Review, and an Audiology Specialist Advisory Group – a single body with oversight of paediatric and adult audiology services which reports to the Scottish Government. We hope and expect that the Scottish Government will establish these groups within the next 6 months.
What about ear wax services in Scotland?
The provision of ear wax removal services was not included in the remit of the Review, but we know that many people in Scotland are having difficulty accessing ear wax removal services. RNID held meetings with Scottish Ministers and officials alongside the Review to press this point directly.
What will we do next?
RNID will continue to engage with the Scottish Government on the quality of NHS audiology services. We hope that the Scottish Government continues to work with us, allowing us to represent patient’s needs on the new forums that come from the Review. We want to see audiology targets work to a new set of standards, informed by the wishes of patients, to ensure patients consistently receive a high quality service.
We will also continue to challenge the Scottish Government over the failure to provide wax removal services across the NHS. If you’ve been personally affected by this issue then you can contact your local MSP.
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