Workforce meetings with NHS England

In the last 10 days, members of the BAA Board of Directors have been involved in a few meetings with NHS England representatives, discussing Audiology Workforce issues.

CSO England

The first meeting was with the Deputy CSO (England) and colleagues in the CSO’s office. The original premise for this meeting was to discuss the 15-year workforce planned by the CSO England’s office. While BAA Board were happy to input into these long-term discussions, the opportunity was taken to highlight the pressing workforce issues we have now.

It was an open and frank discussion, which we hope to continue.

NHS England Transformation Directorate

Our second meeting on workforce issues was in direct response to a letter we sent a few weeks back highlighting our serious concerns about the current and future state of our profession.

We met with key people in the NHS England team and highlighted all our concerns. We talked through the main workforce issues facing NHS Audiology, backed up by evidence from Heads of Service surveys, London data and the NDCS annual survey of paediatric services.

We highlighted the potential impact of these workforce shortages, which include, but are not limited to:

• Long Audiology waiting times/backlogs for reviews
• Risk of professional standards not being met due to workforce shortages and training issues
• Variable service quality (including services where we know quality of care falls way below expected standards for patients)
• Delays in identifying hearing loss in children – leading to a life-long impact on their attainment and emotional well-being
• Adults whose hearing loss isn’t identified and/or managed will have difficulties communicating, access to work, isolation, mental health, and are at increased risk of dementia.
• Lack of capacity resulting in little service improvement and innovation, poor uptake of IQIPs accreditation
• Limited capacity for uptake of the opportunities planned by NHSE for the HCS workforce – i.e. unable to staff Community Diagnostic Centres or meaningfully participate in Physiological Networks

We had suggestions for short, medium, and long-term solutions to the issues we face, which included:

• Urgent review of ESR data for Audiology staff – prioritised by HCS workforce data project so we can accurately plan workforce needs
• Audiology degree course to be added to the list of “high-cost courses”
• Access to learning support fund (parity with other professions)
• Provide central funding for visas and learning modules for international applicants
• Continued review of the PTP
• Ensure placement tariff is sufficient to meet provider costs
• Injection of additional monies to fund apprenticeships (as recently done in Cardiology)
• Funding for apprentice salary, as well as for the academic fees
• Strategy to tackle attrition of graduates to the private sector
• Incentives to retain existing workforce
• Steer from NHSE to trusts to provide placement opportunities for students/shared training posts between trusts/ overcome barriers to collaboration
• NHSE to steer all trusts and ICBs to have Lead HCS who can champion need for a proper Audiology workforce
• Commissioning guidance for ICS to specifically mention workforce standards/expectations

NHS E have pledged to look to action some shorter-term fixes we have proposed. We felt the meeting was positive, with fruitful discussion and everyone appreciating the challenges we all face, with an appetite to help change. A follow up meeting has been arranged for six weeks’ time and a list of actions allocated to work on before then.

What can you do?

Data drives change, and it will transform where we need to be. We can help NHSE help us by:

• Reporting your DM01 data

Many discussions centred around data, as there is a lack of it available. Some data capture points are limited in their scope. For example, the DM01 only captures six aspects, and it doesn’t reflect that we follow that person for the rest of their lives. The NHS E team is looking at how they can make this data more meaningful. Completing the DM01 is mandatory, so we hope you are all completing this. The NHS E team is also working to ensure it captures all AQP sites.

• Checking how your team’s job roles are defined on your trust’s ESR system

The ESR data is also inaccurate, so the CSO England team is working to make this much more reflective of actual numbers working in Audiology. Are your team described as Healthcare Scientists or something else?

• Getting ready for the ‘National Stocktake’ for audiology

The NHS E team will undertake a ‘National Stocktake’ for audiology. Original planned for the end of 2023, the NHSE team has pledged to bring this forward into late Summer 2023. The Audiology Stocktake will be annual and, as well as giving a lot more information, will also shine a spotlight on the gaps.

We are acutely aware that some of the issues highlighted above are not just England-specific. We are keen to support work in other home nations to address issues facing audiology teams in due course.