YOUR LOCAL AUDIOLOGY SERVICES

Transcription

1 Sue Wyatt-Jones

2 YOUR LOCAL AUDIOLOGY SERVICES St. Michael s Hospital Southmead Hospital Cossham Hospital South Bristol Hospital Portishead H/C Clevedon Hospital Stockwood H/C Nailsea H/C Yate M/C Thornbury H/C

3 AQP Any Qualified Provider With the introduction of Any Qualified Provider (AQP), a G.P. is satisfied their patient meets the following criteria any person aged 60 and over with a normal bilateral age related hearing loss, i.e. bilateral hearing loss usually in the high frequencies, has a choice of where they can access NHS hearing aid prescriptions. We want to highlight the range of services we are currently providing for you. This includes a comprehensive assessment, diagnosis and provision of Hearing Aids, with quality at the core of all our care pathways: Available on Choose & Book Short waiting times FREE state of-the-art-digital hearing aids including the latest open fit/life tube technology Lifetime aftercare and FREE batteries Priority repair services across our area for hearing aid repairs and maintenance by appointment Proven high quality clinical outcomes with high patient satisfaction

4 Other Service Information Our Audiology department offers a direct access service for adults of all ages 16 to 59 years with suspected hearing loss and Tinnitus. We also provide services for complex Hearing needs and Vestibular Diagnosis and Balance Rehabilitation. Adults with suspected hearing loss are fully assessed using a range of diagnostic testing strategies, recommendations for hearing aids, assistive devices or other management options are discussed as appropriate. Referrals can be made directly to ENT as required to provide a seamless service for the patient. Adults with Tinnitus The direct pathway caters for all patients who do not meet the red flag criteria for ENT referral. The Clinic is managed by fully qualified Audiologists with specialist knowledge and training providing timely and appropriate Tinnitus rehabilitation, counselling and provision of hearing aids/noise generators as appropriate. St. Michael s Audiology Department also provides a Complex Hearing Needs Service. This is run by specialist Audiologist s and caters for all patients who have a specific complex need. Full Diagnostic & Balance Rehabilitation Clinic in support of ENT for patients who present with undiagnosed/diagnosed conditions causing disruption to their lives through vestibular dysfunction.

5 AQP exclusions: Under 60 years of age History of discharge other than wax from either ear within the last 90 days. Persistent pain affecting either ear (defined as earache lasting more than 7 days and in the past 90 days before appointment) Sudden loss or sudden deterioration of hearing (Sudden=within 1 week, in which case send to A&E or Urgent Care (Hot) ENT Clinic. Rapid loss or rapid deterioration of hearing (90 days or less) If rapid or sudden hearing loss please follow suggestion below from ENT Consultants. If Sensorineural hearing loss (SNHL tuning fork test) GP bleep 2920, request on-call ENT SHO for urgent appointment. * ENT advise that if patient seen within 24 hours start immediately on high dose Prednisolone. Access ENT Hot Clinic or attend A&E.

6 Further exclusions Fluctuating Hearing loss (not associated with colds/upper respiratory infections) Tinnitus unilateral or asymmetrical, pulsatile or distressing lasting more than 5 minutes at a time. Troublesome Tinnitus which may lead to sleep disturbance or be associated with symptoms of anxiety or depression. Abnormal auditory perceptions (dysacuses) Any impairment of hearing involving difficulty in processing details of sound as opposed to any loss of sensitivity to sound. Vertigo, Dizzy or Giddiness, swaying or floating sensations. Normal peripheral hearing but abnormal difficulty hearing in background noise, sound localization or difficulty following complex auditory directions. Recent referral rejected by the Referral Service: please ensure specific request, a unilateral hearing loss was not directed to ENT as this was mentioned in passing and the main request appeared to be an issue with Tinnitus.

7 What causes Sudden HL Many differing causes, this is just a few. autoimmune Cogan s Syndrome, Lupus, Meniere s, Vascular Cardiopulmonary bypass, Sickle cell, vertebrobasilar insufficiency i.e. TIA/Stroke, Small Vessel Disease. Neurological Neoplastic Acoustic Neuroma, Leukaemia, Migraine, MS, Myeloma, Trauma or Toxins inner ear concussion, otologic surgery, ototoxicity, temporal bone fracture, CSF leaf (Lumbar Puncture) Infection and Viral Herpes, HIV, Lassar Fever, Meningococcal Meningitis, mumps, Rubella, Syphilis. Often no known cause for sudden onset hearing loss Effects men and women equally most prevalent in middle age.

8 ototoxicity

9 Sudden loss of hearing what next If the advice above has been followed, and residual hearing remains, having a complete evaluation of their current hearing threshold (if stabilised) and fitting with the most beneficial aid for that loss would be undertaken. If the loss is such that hearing aids cannot assist Cochlea implant referral WEHIP(West of England Hearing Implant Program) GP referral to ENT Hearing Therapy support and information GP direct access referral/referral from ENT & Others Hearing Link Therapy Centres Eastbourne, Wales, Scotland and Ireland Referral via Hearing Therapy & GP

10 Cochlea Implant guidance The above gives guidance on the criteria necessary for implant however the WEHIP welcome referrals and they can then assess if they are suitable for implantation and optimise the hearing aids as necessary. Candidates should have a valid acoustic hearing aid/s for at least 3 months (adults and children)

11 Criteria for implant =NICE guidance For the purposes of this guidance, severe to profound deafness is defined as hearing only sounds that are louder than 90 db HL at frequencies of 2 and 4 khz without acoustic hearing aids. Adequate benefit from acoustic hearing aids is defined for this guidance as: for adults, a score of 50% or greater on Bamford Kowal Bench (BKB) sentence testing at a sound intensity of 70 db SPL for children, speech, language and listening skills appropriate to age, developmental stage and cognitive ability.

12 Hearing Therapy Within University Hospitals Bristol we have 4 specialist qualified staff in Audiology who have undertaken specific hearing therapy training. This enables us to give additional time and support to people who present with sudden hearing loss. We can advice on communication tactics for the patient and their partner. Advise and demonstrate additional devices to assist at home or in work and refer to Access to Work for additional work based support.

13 HT Continued: We give psychological support and assist the patient for up to 6 sessions to enable adjustment to their changed circumstances. If further help needed we would recommend returning to GP for further assistance or re-referral to the Link centre We refer onto other agencies and give information and support to other agencies, employers, schools and ad hoc advice and information as needed. Other agencies may involve -

14 What used to be The Bristol Centre for the Deaf and hard of hearing situated in King Square is now Bristol Centre of Deaf People run by Referral form completion or phone Bristol Equipment Service Situated at the Vassall Centre, Fishponds We also refer to other agencies and support services and Lip Reading Teacher Mary Hall Telephone: lipreadingmary.org.uk

15 HDDP We train clever dogs to help deaf people That s what we do in a nutshell we train dogs to alert deaf people to sounds they can t hear. Sounds we take for granted like the doorbell, alarm clock and even danger signals like the fire alarm. Being aware of these important sounds thanks to a hearing dog makes a real difference in deaf people s lives. Hearing Dogs for Deaf People, if patient and family consent to owning a dog this can be a brilliant option for some.

16 Hearing Link Our vision: people with hearing loss have the knowledge, skills, confidence and contacts they need to participate fully in their world and to overcome the practical and emotional challenges of living with hearing loss =player_embedded The above gives you a link to video s recorded by participants They attended a Hearing Link intensive 5 day program and what they learned about the experience. Totally immersive experience and does not only teach the deafened person but the person attending with them Available in Eastbourne, Birmingham and Scotland Hearing Link also have a community Support volunteers nationwide.

17 Further help and information Pat Smith Head of Audiology St Michaels Hospital Tel:

18 Thank you I m connected to the world again I wish I had done this years ago, what a waste of a life well I m sure I m going to make sure I get the most out of life now! Polite friendly staff. Appointment time met. A great service. Thank you It s so nice to have someone calm and professional who takes time to listen to you My aids are my lifeline to the world Thank you Nothing was too much trouble and the sympathetic help they gave me was of the highest order. They are the best!