#GetInvolved Number 11 – What About Children with Hearing Loss During Lockdown – an Audiologist’s Perspective
My name is Sue Falkingham, by profession I’m an Audiologist, I work for Starkey Hearing Technologies as an Audiologist and a trainer. I’ve been an Audiologist for 30 years this year and I love it!
I’m also the Immediate Past President of the British Academy of Audiology, we are the biggest professional body for Audiology in the U.K. with most of our members working in NHS Audiology.
It became very clear whilst I was visiting an Audiology Department in Nottingham to do some training on 17th March that our lives were about to become very strange, for a significant amount of time. This was before the pubs, theatres and cinemas were asked to close and before we all went into lockdown. It was the last face to face piece of work I did.
So what happened?
That day the department received a message that they must cancel all their outpatient clinics for a month and must do it immediately, within minutes the messages were pouring into BAA as a group and individuals explaining similar emails and messages had been sent out to most NHS audiology departments in the country, with the cancellations to all routine clinics being for between 1 month and 3 months.
The feelings attached to a moment like that are immense and as an outsider watching a large group of people both in person and online react to that news was a very emotional thing. In one clinic it was 2,000 appointments in 4 weeks.
Shock, fear, anger uncertainty, concern a collective pulling on of the big girl and boy pants and doing what needed to be done became the order of the next few days.
By Friday schools, and pubs had been closed and on Monday 23rd the announcement that the whole country would go into lockdown happened but for those first few days I watched friends start to get to grips with what was a sudden announcement.
Audiologists are caring, concerned individuals who are problem solvers and scientists as well. As a profession we quickly understood the need to release capacity, to limit the amount of people in our NHS buildings and to protect our patients. Audiology in the main is not the frontline of the NHS but it is a vital service. We deal with often vulnerable people who have or develop problems with their hearing and balance systems.
So what is essential in Audiology and can we just stop all activity for up to 3 months?
Luckily nobody really wanted to stop all activity, what they wanted was to limit and if possible to stop all face to face contact, but nobody wanted people who rely on their hearing technology to communicate to stop getting repairs and batteries so they can remain connected and hearing through these challenging times. Departments all over the country started to share new ways of working, new ways of getting things to their patients, from standard postal services, to drop offs by car at patients homes when the audiologists were travelling in or out of hospitals, to local bicycle services for a more rural place. You can help maintain a 2m distance for this type of service easily.
The problem is at a safe 2m distance you can’t look in ears, you can’t take ear impressions and some of our testing gets difficult to do.
The first big piece of work I got involved with at BAA was around the testing of newborn babies who failed their hearing screening on the maternity units. Normally they have to come to an audiology service somewhere for more detailed testing and for potentially being diagnosed with life changing hearing loss. We normally want to test babies that fail the screen quickly, it reduces parental stress and allows any interventions we might want to discuss to be done at an early stage. The maternity screening programs are managed by Public Health England and are part of many tests done in Maternity, they are often very separate from Audiology services, Public Health England were a little busy and screening seemed to be a very small thing but we needed to get some clarity on how, when and by whom babies would be followed up. We initially put together a very small working group to write to PHE and express concern about baby screening and over the next 2 weeks that fabulous group worked with the screening managers at PHE to pull together guidance for services which was published on 30th March. The one thing the Corona Virus response has taught me is the speed things need to move at in health services has never been required before.
That small group of professionals is now conducting online meetings to answer questions that come up from individual locations and produce guidance for when we can switch back on our diagnostic services. It’s something we are hearing a lot about in this crisis but one of the questions for this group has been what personal protective equipment do you need to see a baby and be protected from Covid-19?
So now we have an immediate response but we then realised there is a lot of work to do as a Professional Body to try and support our members. We planned an online meeting of the Heads of Audiology Services, it gave over 100 people managing services a safe space to find out how other services were coping, what information was available and just to know that what they were doing was appropriate and similar to other places.
One thing has also become clear, audiologists have many transferable skills that can, during this period of crisis be put to use. So we started to see Audiologists being redeployed to other areas of the hospital. We’ve seen them retrained to test the fit of PPE, to safety test all the new ventilators and equipment coming in, to help staff from the frontline in wellbeing centres, to clean wards, to help in medical records, and to work in bereavement services. Audiology is part of the Healthcare Science Workforce and at times like these with rapid up skilling and supervision there are many skills we can put to use elsewhere.
Back in audiology departments a skeleton staff is still looking after their existing patients and seeing a few new emergency cases with ENT specialists. At BAA we initially released our own guidance on how services might do this safely and we have recently collaborated with other professional bodies to release a sector wide guidance.
It Also became clear that some patients were anxious thinking their usually audiology services were closed, they definitely are not. We started a social media campaign using messages from local NHS departments, sharing new ways of working, more direct support materials for patients and in some cases new contact and opening times. Look up our campaign using #StillHereForYou to see those great messages.
So what is happening to support this in my commercial “day job”? If a hearing aid needs fixing and the audiologist needs to send it to the manufacturer the manufacturers still need to be open. We have also adhered to best practices and most of our non production staff are working at home. In our factory a small number of staff go in to send out orders, manufacture new products and get them out to audiologists or direct to patients to help them continue to hear.
We have some really high tech production facilities and one of the things we are doing is “growing” children’s earpieces to fit their growing ears. Normally an audiologist might take a new set of ear impressions every month for their smallest patients, we would scan them and 3D print a new set of earmoulds. The audiologists can’t do that as they aren’t seeing the children face to face so we are adding a growth estimate to some of the scans we have on file for a child and making them bigger.if we don’t do that the children will have whistling hearing aids that will not help them hear.
Personally I am providing support and training to our customers on products online. Many of our high street customers have more time on their hands to learn as they are also only seeing people remotely, so it’s a great time to be productive and learn.
Many of my online conversations now revolve around what personal protective equipment audiologists will need to get back to face to face work. Generally we have never had to wear it before, generally good hygiene standards is all we have needed, does this have to change? If there is a global shortage of PPE what will audiologists be able to get and when is also a factor in returning to face to face contacts. The professional bodies need to put out more guidance and soon, so I’m also trying to start that piece of work with other interested bodies.
So what do I want to end this with? Audiologists are adaptable healthcare professionals. They are still able to help their patients mainly remotely and they will be back soon, rebooting their services and adapting to a new normal.
If you are worried about yours or a child’s hearing devices contact your normal NHS services and they will be there for you.
And wash your hands
Connect with Sue on Twitter @swimto40
Connect with Starkey Hearing Technologies @Starkey_UK