The service user’s view Susan Daniels Chief Executive National Deaf Children’s Society

Deaf children Over 50,000 in the UK 5 born every day Early identification and accurate diagnosis is crucial Deaf children can do anything hearing children can with the right support - high quality audiology services are key in achieving this Working to ensure deaf children can access high quality public services has been key to NDCS since our formation in 1944.   There are over 50,000 deaf children in the UK and 5 are born every day (I know this is from the new key messages, but NHS England are already using 51,000 so maybe worth using on this occasion for consistency). Deafness is a not a learning disability and deaf children demonstrate the same range of skill and abilities as other children. If deaf children are given the right support there is no reason why they should not reach the same levels of attainment as other children. NDCS believes that one of the key elements of a deaf child’s success is the early identification and accurate diagnosis of hearing loss. This needs to be followed by the provision of high quality audiological, education and family support throughout childhood, but the right support in the early years is especially important.

What do service users want? A service that is fit for purpose, i.e. of good quality - a badge of accreditation means that they can be confident this is the case. Service users to us means deaf children AND their parents/carers. All service users want to access a service that is fit for purpose and a badge of accreditation or quality means that they can be confident this is the case.

To achieve this service users want: arrangements in place to ensure services are fit for purpose accountability mechanisms for ensuring action is taken if the service is operating below required standards To ensure that this is the case, service users want 2 things, 1. arrangements in place to ensure services are fit for purpose and 2. accountability mechanisms in place for ensuring action is taken if the service is operating below required standards. There is plenty of evidence to show how much parents value Ofsted judgements and reports when choosing a school for their child. It is not unreasonable to expect the same information about their local audiology services.

These arrangements include: Clear standards which describe what a service that is fit for purpose looks like An independent assessment of all providers by appropriate qualified people to determine whether a service meets the standards Transparency in that process These arrangements include: Clear standards which describe what a service that is fit for purpose looks like An independent assessment of all providers by appropriate qualified people to determine whether  a service meets the standards Transparency in that process (e.g. it is made clear who meets the standards and who does not, why and what needs to change to meet the standards)   There would be a public outcry if Ofsted stopped publishing its reports on how well schools and early years or only inspected establishments that volunteered to be inspected.

Risks if these are not in place… service quality can fall as there is less incentive for commissioners and providers to reach and maintain standards audiology services for children are particularly vulnerable as they are less likely to be in the public spotlight Without such arrangements there is a risk that service quality can fall as there is less incentive for commissioners and providers to reach and maintain standards (e.g. it is easier for decision makers in health to make cuts in areas where the QA and accountability arrangements are weak). Services such as audiology services for children are more vulnerable because they are less likely to be in the public spotlight than services such as A&E, cancer, mental health.

What this means for deaf children For example, hearing aids and equipment that does not fit or work properly can contribute to to: delays in developing language falling behind at school more support needed from health and education services later What these risks mean for deaf children and their families are far reaching. Poor audiology care for deaf children can, for example, result in hearing aids and other equipment which does not fit or work properly. Meaning that deaf children are left in their crucial early years without as much access to sound as they could have which can delay communication, language and social and emotional development. For children at school it could mean that they are less able to follow their lessons and that they fall behind. They may need more support from public services in the future.

Combatting the risks Audiology services for children are less vulnerable if stronger formal quality assurance and accountability arrangements exist. The Newborn Hearing Screening Programme Quality Assurance programme did this well, but ended in 2012 Accreditation has the potential to be a viable alternative but only if it is applied to all services and the process is transparent.

IQIPS – measured against the criteria outlined above Has standards that describe the attributes of a service that is fit for purpose Yes Services are independently assessed against these standards The independent assessment applies to all services No. Voluntary participation – so far only 15% are accredited Transparency Very limited – NDCS had to issue Freedom of Information requests to find the information :

What service users have told us… I am very happy with my child's audiology care but feel that the future and integrity of this service is so vital that it requires a system of accreditation and constant review and continuous development and improvement to maintain the quality of care. I only have information about the quality of my local children's audiology service… because the National Deaf Children’s Society carried out Freedom of Information requests to find out. In February, following our survey of children’s audiology services in England in which we asked question about IQIPS, we shared the information we had gathered with families of deaf children on an online map and asked them to contact their local CCG about the services they commission. Here are some of their views on accreditation.

..about an accredited service My daughter Emily benefits every day from wearing hearing aids your services have supplied. Without the help and support from your audiology team, her education and social integration would have suffered greatly. Thank you for your continued help in giving her the opportunity to engage with life alongside her peers.

IQIPS The programme should be mandatory for all children’s audiology services, so that deaf children and their families can be confident in the quality of the services they are receiving. Until it is it needs to be championed and promoted by people like you. The survey we carried out showed that accredited services were less likely to report staffing reductions or problems with waiting times. They were also more likely to have a training programme than those that weren’t which is why we believe the programme should be mandatory for all children’s audiology services, so that deaf children and their families can be confident in the quality of the services they are receiving. Until it is it needs to be championed and promoted by people like you. .

NDCS resources Lessons from accredited paediatric audiology services document - http://www.ndcs.org.uk/document.rm?id=11089 The health of children’s hearing services in England map and report – www.ndcs.org.uk/listenup