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Barts Health PAWG Eddie Herter Waheeda Pagarkar Ratna Shah Jo Page Margaret Baldwin Watkin PM September 2014 Building the System National System of Care.

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Presentation on theme: "Barts Health PAWG Eddie Herter Waheeda Pagarkar Ratna Shah Jo Page Margaret Baldwin Watkin PM September 2014 Building the System National System of Care."— Presentation transcript:

1 Barts Health PAWG Eddie Herter Waheeda Pagarkar Ratna Shah Jo Page Margaret Baldwin Watkin PM September 2014 Building the System National System of Care for Children and Young people with Hearing Impairment The next steps in Building the System for NE London

2 … joining up all audiology services for 5 districts Redbridge Waltham Forest City and Hackney Tower Hamlets Newham

3 Redbridge 68,981 Waltham Forest 76,261 City and Hackney 79,682 Tower Hamlets 74,485 Newham 100,864 … joining up all audiology services for 5 districts – 400, yr olds

4 Redbridge 68,981 Waltham Forest 76,261 City and Hackney 79,682 Tower Hamlets 74,485 Newham 100,864 Barking, Dagenham and Havering 99,079 … joining up all audiology services for 7 districts – 499, yr olds

5 Redbridge WXH sites- 3 rd Tier 2 nd Tier – None School Nurse Screen by NEL Foundation Trust Waltham Forest. WXH sites- 3 rd Tier 2 nd Tier – None School Nurse Screen by NEL Foundation Trust Tower Hamlets Hackney Ark- 3 rd Tier Royal London + Steels Lane HC-2 nd Tier School Nurse Screen by Barts Health City and Hackney Hackney Ark-3 rd Tier Hackney Ark + John Scott HC – 2 nd Tier School Nurse Screen by Homerton UH Trust Newham West Ham Lane-3 rd Tier West Ham Lane-2 nd Tier School Nurse Screen by EL Foundation Trust … joining up all audiology services + Education Waltham Forest Redbridge Newham Hackney Tower Hamlets Barking and Dagenham Havering ENT Acute Surgical Homerton University Hospital ENT Acute Surgical Royal London Teaching Hospital ENT Acute Surgical Newham General University Hospital ENT Acute Surgical Whipps Cross University Hospital

6 … joining up all audiology services through commissioning Local CCGs Waltham Forest, Tower Hamlets, Newham, Barking and Dagenham, and Redbridge, NHS England, Barts Health and other local providers have established a clinical transformation programme called Transforming Services, Changing Lives. A key element of the programme will be to consider how best to ensure safe, effective and sustainable hospital services at Bart's Health and Homerton hospitals, set in the context of local plans to further develop and improve primary, community and integrated care services.

7 … joining up all audiology services through commissioning What does good look like What is working well What is not working well What are the constraints commissioner support to implement the National System for an integrated NELondon Audiology System

8 … the plan to join up all audiology services The National System of Care for Children and Young People with Hearing Impairment North East London CHSWG Parents NDCS Health + Wellbeing Boards i. Council ii. Health watch iii. CCG iv. Children Services v. Public Health vi. Social Services

9 … the plan to join up all audiology services Health + Wellbeing Boards i. Council ii. Health watch iii. CCG iv. Children Services v. Public Health vi. Social Services

10 … the plan to join up all audiology services Health + Wellbeing Boards i. Council ii. Health watch iii. CCG iv. Children Services v. Public Health vi. Social Services The National System of Care for Children and Young People with Hearing Impairment North East London DRAFT REPORT SEPTEMBER 2014

11 … the report to the H+W Board Identification of Deafness Access to accurate diagnosis The provision of clinical care The provision of integrated support WHAT? NHS CCG Paediatric Audiology Provider Borough BY? eSP and SMaRT Clinical Reporting System Shared register updated from eSP and SMaRT BY?

12 Accessible, Readable and Interesting and Contains……… i. Scored Performance Statements ii. Tabulated Performance measures iii. Epidemiology report iv. Action plan The National System of Care for Children and Young People with Hearing Impairment North East London DRAFT REPORT SEPTEMBER 2014 … the report to the H+W Board

13 The NHS in East London has to meet the needs of some of the most deprived areas in the UK and providing care for children and young people with hearing impairment today whilst planning for tomorrow requires the availability of robust local evidence on the epidemiology of hearing loss. To achieve the best outcome for every hearing impaired child they must receive the best clinical care delivered by high quality medical and surgical services. The most beneficial amplification must be available to them – including when required early access to implantable devices. The provision of clinical care For children with persistent or permanent childhood hearing impairment (PCHI) by Provider Paediatric Audiology Clinic(s) WXH Paedi atric Sites All parents of babies and children with a confirmed PCHI are offered referral to appropriate medical consultants for aetiological investigation and assessment in a timely fashion – evidence based or informed by professional guidance All appropriate cases are offered hearing aid fitting within 4 weeks of confirmation of hearing loss unless delayed for management reasons - measured by the NAS12 Performance Indicator Appropriate hearing aids are fitted according to MCHAS or other accepted professional guidelines and programmed with appropriate features using real ear measures and prescriptive fitting rules. Robust on-going audiological care is proactively provided throughout childhood including regular checking and replacement of hearing aids, hearing aid settings, and use in the home is carried out. This information is shared with colleagues to form part of the child’s integrated support and audiology care plan. *A hearing aid repair, ear-mould replacement and battery issuing service is available and accessible to parents and other professionals each working day throughout the year Hearing aids, listening systems and other devices have been purchased through a regularly audited joint procurement system 90% of profoundly deaf children identified by the NHSP whose parents wish for implantation are implanted before 12 month - measured by the NAS13 Performance Indicator Promote awareness of and raise awareness among healthcare professionals of the preventable causes of hearing impairment with information available in all healthcare settings Provide robust evidence to support the epidemiology of hearing loss with the aim of reducing the number of children with preventable hearing impairment per 1000 births The National System of Care for Children and Young People with Hearing Impairment North East London DRAFT REPORT SEPTEMBER 2014 … action plan to the H+W Board

14 The National System of Care for Children and Young People with Hearing Impairment North East London DRAFT REPORT SEPTEMBER 2014 … action plan to the H+W Board Improving Identification Whilst the Neonatal screen is undertaken to an approved national standard and routinely reports validity data – this is not the case for the School Entry Screen. The possible movement of school nursing services to Public Health and the availability of a designed screen reporting programme (SMaRT) provides an opportunity for Audiology to work with the school nursing services and Public Health to reverse this situation.

15 The National System of Care for Children and Young People with Hearing Impairment North East London DRAFT REPORT SEPTEMBER 2014 Improving Diagnostic Services  The IT systems are not yet in place to report all the measures required to assess the level of performance of this System component. Performance reporting can be built into the Clinical Reporting System.  Not all the standards have yet been agreed eg the performance measure to evaluate the implementation of an appropriate system of “Watchful Waiting” and national rather than local measures should preferably be employed. … action plan to the H+W Board

16 The National System of Care for Children and Young People with Hearing Impairment North East London DRAFT REPORT SEPTEMBER 2014 Improving Clinical Care Measuring the performance of our Clinical Care requires the further development of the integrated register of PCHI with data imported from eSP and SMaRT. This should also be the basis of the annual epidemiological report made to Public Health. In addition it is clear that we are not achieving the target for Cochlear Implantation in infancy. Evidence should be made available from the register with improvement targets set. The integrated register should also enable co-ordination of clinical activities with the educational service. … action plan to the H+W Board

17 The National System of Care for Children and Young People with Hearing Impairment North East London DRAFT REPORT SEPTEMBER 2014 Improving Integrated Support  Although the Local Offer has been co- produced in some of the NE London boroughs, an agreement (with terms of reference) has not been co- produced between local Education Services and the Audiology Service detailing how service providers will give integrated support to deaf children and their families is required. There is now an agreement with local Audiology Services that there will be an integrated agreement produced and available for Children’s Services in both boroughs. … action plan to the H+W Board

18 and to follow………………….


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