CHSWG 17th November 2022
Attendees: S Winterburn, S McGlynn, T Stott, H McCann, J Wilson, C Baron, H Hodgkinson, P Pinder, H Badje, T May, J Thomas, D McLeod
Apologies: S Sutcliffe
J Thomas as Chair welcomed everyone to the meeting and was pleased, we now had TOD representatives from Lancashire.
Audiology
S McGlynn stated that although they still had a lot of patients not attending appointments, the texting service and reminders 7 days and 1 day before had improved the numbers attending. There had been an increase in staff with a new Band 5 & an experienced Band 6 joining the team along with an extension to the locum post. There is still a lengthy waiting list but it is improving. Positive feedback regarding new Oticon hearing aids, Blackpool area increasing Radio aids, with Lancashire already doing this.
APD locum contract extended, there is a large waiting list but this is partly due to increase in referrals, currently seeing late 19/20 referrals. Once seen the pathway is quick.
A new lead from Adult Services working with Transition, Gemma Foster NDCS pre-Transition clinics keen to work with Audiology.
New hearing aids connectivity good although difficult with Apple devices as need connect clip, Sally asked if this is an area NDCS family fund could help.
Children are signposted to Sign Hi and those children are more positive with hearing aids.
DM to check Sign Hi mailing list as Audiology had not received latest programme.
TODS Blackpool
December PHSE course postponed until January and will take place at Solaris centre. Help prepare kids for 6th form and adulthood, money skills etc. Sign Hi agreed to provide funding for this event. Regular visits to children were continuing, but if anything, urgent TODS can be contacted.
TODS Lancashire
Process and Procedure documents being produced by Lancashire TODS to enable them to work
as a team and also share good practices, staff meetings are being held and hours and capacity of the team being considered. There are 9.7 FTE Lancashire TODs
NDCS
H Badge stated it was positive that a lot of Joint Working was taking place in Lancs and Blackpool area. There is a section on NDCS website regarding CHSWG including sharing stories, how they work in rural and disadvantaged area.
CHSWG Workshops are held for both parents and professionals covering Chairing, engaging, challenges/solutions etc.
JT stated we had done some work with Sarah Colinson(NDCS) reviewing CHSG Action Plan, H Badge confirmed many groups were using the template.
AOB
JT asked how often other CHSWGs meet, HB said they varied but some have more frequent meetings for 1hour with various actions, also could have sub groups for specific actions/issues, possibly Task and Finish Groups.
A general discussion took place regarding SLT and the lack of provision in the local area, as previously discussed/agreed it was felt that due to low numbers it should be a shared model
Blackpool/Lancashire similar to the Cheshire / Merseyside model which brings more stability and stronger structure. It was agreed that SLT was key in children’s development and should
……………………………………………………………………………………………………………………………………………………..
CHSWG 10th February 2022
Attendees:
J Thomas, K McLeod, H Badje, J Wilson, T Stott, M Simey
Apologies:- D McLeod, A Crawforth, S McGlynn
Tods
Phil Thompson has left Blackpool Council and currently Angela Wellings has taken over his role. JW has done on-line training for Oticon and Phonak aids. Feedback has been positive with children really likely their new aids.
HM has had a couple of referrals through new born screening. Has one who is profoundly deaf and she is trying to re-establish play and stay at a local children’s centre on Grange Park.
Collette Goucher will not be replaced
JW wants all her caseload to see SLT. Helen McCann refers all her caseload to triage which is within the Blackpool Council. They determine the appropriate route depending on whether the child’s speech is age appropriate. There is a contract with a private provider to provide support and if there is a significant need they are referred to the NHS, but this is only generic SLT not deaf specific. Also they don’t sign so are not able to support children who sign rather than use speech.
There is a review of 2 year olds by health visitors. This may provide evidence that deaf children need deaf specific SLT. TODs are engaging with Health visitors to find out the outcome of the review.
One TOD HM is to have an enhanced role liaising with the Senior Health visitor. She currently already liaises with them as part of her role.
JW had lots of support while she was off and HM provided cover. JW has had 3 referrals in the past 6 months, 1 of whom has just been diagnosed and another has moved into the area.
SLT
Marie Gascogne has now left so no deaf specific training for SLT Therapists. Sarah and Louise were unable to attend today’s meeting. The situation continues that while generic SLT is available no progress is being made with the provision of deaf specific SLT.
HB said the covid has had a significant impact on all SLT as resources have been focused on dealing with the pandemic. SLT therapists are now returning to their roles so we need to have sight of a recovery plan to ascertain where deaf children are in the system.
Commissioners could do spot commissioning for those who are most in need, but a route may be via the SEN Board on which JT sits to facilitate a pathway to specialist SLT.
An external review is being undertaken and needs specialist input. Marie Gascogne was leading it. HB believes that a Sarah Campion is now involved. As there are only a few children needing deaf specific SLT an option would be to commission into a specialist network
Such as Cheshire and Merseyside.
It was agreed that next steps are
- Liaise with Marie Gascoigne to find out about review
- Engage with Sarah Campion
- Engage with specialist network Alison Moore has replaced Sheena Round.
NDCS
Signed BSL is being formally recognised as a language. NDCS are involved in assisting those responsible for the bill. A profoundly deaf MP introduced the bill.
NDCS requested the CHSWG update be circulated to encourage parent/carer involvement. JT stated that SHSH always contacts members prior to the meeting to ask if there are any issues anyone wants to raise.
NDCS are also running workshops about the role of CHSWG to encourage parent/carer involvement. They also run other CHSWG workshops for professionals.
HB mentioned that during the pandemic NDCS had developed an action plan for CHSWG’s to use to capture actions and she is happy to talk through it at the next meeting. It ensures records are kept in one place so the history is not lost. Also can help condense the minutes.
Sign Hi
Activities have resumed post covid and participation continues to increase.
AOB
JT asked about specialist CAMS as she has never seen anything regarding a pathway for deaf children. There is a generic pathway for other specialist CAMS. JW stated she has just contacted them direct and not had any issues. HB stated that Mental health for children and young people should include a route for specialist conditions and details should be included in the local offer.
SEN Board use the Parents Forum as their sounding board and deaf needs have no representation or input. There is no member of the SEN Board who specializes in Sensory impairment. As there is a low incidence of deafness the focus is on those disabilities with a higher incidence. There was a suggestion that someone from the Parent Carer Forum should be invited to CHSWG to gain an understanding of deaf issues.
HM stated they are still waiting for the OFSTEAD review
Date of next meeting Wednesday 15th June 2022
…………………………………………………………………………………………………………………………………………….
CHSWG 11th November 2021
Attendees:
J Thomas D McLeod A Crawforth H Badge C Clarkson S Sutcliffe S McGlynn
Updates
Audiology see report from Michelle.
- Staffing update: Many pluses in that we have extra staff but there has been some associated training demands.
- We have two trainee doctors who are due to hold their own clinics as from this month. Dr Haider is currently concentrating on APD and hyperacusis and Dr Sirajuddin will be seeing other caseload.
- We have recruited a new band 5 who will start mid January 2022 and a request has been made for a band 6 who we hope to recruit before the end of the fiscal year.
- Kirsty, our ATO is returning from mati leave on 1st Dec.
- We have an additional temporary ATO until September 2022.
- The admin team have been involved in a Division wide review and as such we have lost Jennifer Slater to the admin team at Ashton. Julie Greenwood has also been replaced by a new office manager who will overview several admin teams. Recruitment is out for a part-time band 2 replacement.
- Balance Equipment
- We have (long awaited) dedicated balance equipment and Dr Ahmmed is currently reviewing its application. All Audiologists have had some introductory training. This offers great benefit to children as it will allow a full assessment of their hearing and balance systems. Dr Ahmmed will be providing referral criteria for children who are eligible for balance assessment in due course.
- Was not Brought Policy
- Our Trust has introduced a new ‘Was not Brought’ policy to recognise that children are dependent on their parents/carers to bring them for appointments. This is linked to more robust safe-guarding protocols which is beneficial for children. It replaces the DNA policy.
- Waiting Lists
- Our locums continue to give great support for the APD and community 2T caseloads. Together with the Audiology team, there are significant improvements in the number of children on the APD waiting list. We would be grateful for feedback on the APD information sheet distributed at the last BLP CHSWG.
- The school hearing screening team have also caught up with the backlog of children not tested due to school closures during Covid.
- We continue to monitor our waiting lists monthly and prioritise accordingly. We are grateful for opportunities to attend WGD more often although staffing levels can restrict us attending every time.
- Oticon Hearing Aids
- These are being rolled out and so far the children that have received them have been impressed with the sound quality and technology features available.
- Service Specification and referral criteria
- This is an on-going piece of work by Michelle and Dr Ahmmed. Dr Ahmmed has been tied up with training the new medical trainees. However, this is on the agenda for attention.
I have also re attached the APD information as Sally stated Dr Ahmmed and Michelle were really hoping for some feedback on if possible.
Jane Thomas asked if Audiology call children for appointments Sally confirmed that they are always called for annual review, if parents are concerned that there is a problem they can contact audiology if they think appointments need to be brought forward.
There has been a large increase in patients not attending appointments (DNA), there has been a huge effort to reduce this and reminder calls the day before appointments has a significant impact.
Tods
Angela confirmed that Jacqueline Wilson be returning to work on a phased return. Helen McCann has been doing extra work to cover.
A child had recently moved into the area and required a communication support worker, the child is a BSL user and the support worker would need to be at least level 3 BSL qualified. Angela asked if any member was aware of anyone who could carry out this role as she had nobody available and agencies did not have anyone either.
Tods had attended Phonak and Oticon training, Aids will connect to Bluetooth, devices can stream music direct, Apple devices do not require a connect clip whereas Android do.
Lancashire are keen on Oticon using classroom microphone system and can connect Rodger.
New Born Screening
Collette confirmed that they had been struggling with staff shortage due to sickness although staff are now back and KPIs are being met. Still getting a lot of people not attending (DNA) appointments with reminders being left and also speak to parents but still do not attend.
SLT
Sarah confirmed there was no pathway for deaf children, this has been flagged up in Service Review. Marie Gascogne and Anna? who covers all Lancashire ??? Don McLeod stated that himself and Jane Thomas had attended a meeting with CCG a few years ago to present a case for specialist SLT for deaf children and the CCG had agreed to commission this. Hazel Badge and Sign Hi had done considerable work to get this moving and Blackpool SLT staff had received training from the Manchester cochlea in plant centre with a view to taking this forward in house.
There does need to be a pathway and appreciate that resource maybe shared between different areas due to the small numbers involved.
NDCS
CHSWG Workshops are being run for both parents and professionals, proving popular and booked up to April.
A discussion took place around using NDCS CHSWG Action Plan, Hazel suggested using SLT as an example template at next CHSWG.
Sign Hi
Don Mcleod confirmed that families had recently attended Glazey Days and around 90 people had booked for the signed version of the Panto along with around 50 for the Christmas party. It was hoped that fortnightly sessions would start in the new year as things started to become more normal.
AOB
Jane Thomas asked if any member wished to takeover as Chair as she had been Chair for 3 years, Jane agreed to remain as Chair until June 22.
Collette asked if GP E referrals for children new to the area could be referred to Fulwood Audiology, it was agreed they can.
Date of next meeting 10th February 2022
……………………………………………………………………………………………………………………………………………………….
CHSWG 8th June 2021
Attendees: J Thomas, H McCann, J Wilson, H Badge, T Stott, D McLeod
Apologies: J Russell, H Connolly, S McGlynn, Dr Ahmed.
Points arising from CHSWG 9th February 2021
SLT JT stated Sarah Sutcliffe had contacted her to arrange a meeting to discuss SLT. Unfortunately neither Sarah or her colleague could attend this CHSWG due to other meeting commitments.
CHSWG member updates
A representative from Audiology was unable to attend, but Sally McGlynn has provided the following report:-
- After receiving training on Phonak and Oticon aids and seeking feedback from Education colleagues, we are planning to update our hearing aid stock with the new Oticon aids. This will start in October.
- We are reviewing our referral pathways to bring in line with the Service Specification drawn up with the Commissioning team. This will affect both tertiary and 2T pathways and will be shared with Children’s Hearing Services in the next 2-3 months
- New APD pathway is working well and we are seeing improvement in this waiting list but there is still a considerable catch up partly due to Covid delays.
- Please can we have some feedback on the patient information leaflet regarding APD. Email Dr Ahmmed with comments. Ansar.ahmmed@lthtr.nhs.uk
- We are hoping to increase our clinic activity at either St Annes or WGD on a temporary basis so that we can catch up with some of the Covid backlog for BFW area.
- We have new tympanometer equipment –Tympstar pro- that we will be setting up at WGD in next month.
- We are progressing with Transition to the Adult Audiology services in the same format as we did in 2019 with Face to face appointments which will be joint with the adult team. Appointments for Pre transition and Final are predominantly in June and July. Feedback following 2019 Transition was good with young people feeling they were well informed and well prepared for their transition which is why we feel after the disruption of 2020 and many young people having missed their routine Audiology appointment last year that Face to face appointments would be most valuable including face to face meeting of the Adult audiologist.
- Face masks are still in use in all appointments by staff and patients unless exempt. We have managed to get funding for iPads in clinic which can be used with a app which types as we talk to assist with communication where required. This are fairly new and have not been used many times yet but have certainly proved helpful so far.
See NDCS report.
It was agreed that the NDCS referral tool for Social Care was useful. It acted as a front door for early help and understanding of needs of deaf children, including neglect around language. The tool kit covers NDCS key messages and can be used as a lever to get social care involved, providing access to transition and equipment etc.
Tracey Stott confirmed that she had spoken to Lancashire regarding transition to adult services but there did not appear to be a pathway.
Helen McCann stated she had attended a Lancashire Training session and TODS had also been looking at new Audiology equipment. Jacqueline Wilson stated that a post 16 Sensory Workshop is to be held covering best practice, preparing for adult hood etc. Hazel Badge stated that she was working with HI and VI teams on a pilot in Manchester bringing employers, youth networks together.
Don McLeod stated that Sign hi had continued to hold zoom quizzes and competitions to stay in touch with families and that the first face to face session was held on 26th May Walking with Alpacas, it was so popular obviously being the first event since lock down that we had to hold 2 sessions to accommodate everyone. A new programme of activities has been produced however, this is subject to any future restrictions.
AOB
Jane Thomas to email New Born Screening ( Colette Clarkson) for representation at CHSWG
Jane Thomas stated that Colette Cocher had left Blackpool Council and was not being replaced.
Date of next meeting -7/10/21
…………………………………………………………………………………………………………………………….
CHSWG 9th February 2021
Apologies: Angela Crawforth
Minutes: D McLeod
Attendees: J Thomas, S McGlynn, J Wilson, T Stott, H McCann, J Russell, S Collinson, H Connolly
Introductions and Welcomes
Matters Arising
JW stated that the language was incorrect where “JT and DM had stated this had been an area of concern and that due to a low percentage of deaf children Send were not really interested in deaf issues”
DM stated that the wording could be changed however, the issue that Colette was addressing /leading arose during CHSWG June2019 and concerns were highlighted again at last CHSWG and there still had been no updates received. Jane Russell confirmed that SLT had an been an issue.
DM expressed his disappointment that another 4 months had passed and yet there is no evidence of any progress. This was of particular concern as a number of people had put a lot of effort into providing Specialist SLT for Blackpool children and the plan was to have a structured Pathway going forward for families with hearing impaired with SLT needs to access.
SC stated NDCS would provide support.
Audiology Report
Sally confirmed that Audiology were still holding face to face appointments covering new referrals, reviews and ear moulds. Repairs were also continuing.
Two locums have been taken on, one in November and the other recently, they are covering APD caseloads and secondary tier clinics.
A school screening service was being provided in Chorley, Preston and South Ribble and Michelle Simeon had asked if this would be useful in Blackpool. It was agreed Michelle would contact TODS to discuss.
An internal review was taking place which highlighted staff shortages and under funding.
Bone conduction aids are being reviewed along with new ranges of hearing aids, Sally said audiology would be interested on feedback from education.
JW stated she had attended a zoom call re Phonak aids which sounded good. SM suggested TODS should consider Oticon aids with wireless microphones.
SC stated that Plymouth were piloting a Rodger system and there was an opportunity for a rapid step change. SC said she was happy to link in with Blackpool.
SM recommended that TODS consider some of the latest equipment available. JW agreed to contact Oticon and Phonak reps.
APD.
SM stated DR Ahmed likes to know what is happening on the ground and was interested in how TODS were progressing with school assessment tool.
TODS
JW stated that one to one visits were with children with high needs and CSWS were working with children with EHC plans.
HM confirmed that she has a zoom call with one family every day.
SM asked what contact was being made with Lancashire families as a number had stated that they had not spoken to anyone. HC confirmed that Lancashire tend to contact schools and not parents directly. SM asked for an email address to enable parents to contact Lancashire, as often they do not know who to contact.
SC suggested that zoom/digital sessions could be held to engage with families.
JR confirmed as a Lancashire parent there is not the same relationship with TODS as in Blackpool.
HC stated that a letter is issued providing TOD name but this varies with different staff and locations, it was thought information leaflets could be provided. HC to consider.
SC asked if Audio shoes are provided, SM suggested that TODS could recommend direct audio input leads.
JW stated some children were not wearing their aids because of using headphones when on iPad etc.
Sign Hi
DM stated that Sign Hi were keeping in touch with families via zoom and obviously were unable to hold any events. Sign Hi sent Amazon Christmas gift vouchers to families as we were unable to hold our Christmas party and many families contacted us to express their appreciation.
JT asked JW how much Children’s education is going to suffer due to lockdown, there were issues with stress and anxiety. H M stated it was difficult especially where children had a support worker and no access to a desk when trying to do video sessions.
NDCS
SC recommended that members look at the referral tool for social care as it was very good.
Career’s campaign which is piloting tool kit with some good examples.
Ready Study being carried out by Aylis Young open to 15 -19 year olds literature review?
Parents as Partners training for professionals in CHSWG multi agency settings.
JR stated transition to adult services works well in Blackpool but was not sure how it worked in Lancashire. HC stated that she was not aware of a similar role to Tracey’s in Lancashire.
It was felt a meeting with Lancashire colleagues would be helpful, TS to identify a contact.
SC suggested a link with careers as young people often don’t know about employment support and may restrict their choices. SC and TS agreed to have further discussions.
JR felt there was little support in Lancashire for year 10 pupils in completion of PIP forms etc.
SMC stated Audiology were doing a transition pack which sign posted a lot to NDCS and that health transition was doing okay but was always looking to improve.
SC stated there was a restructuring of Child and Family Support.
A.O.B
It was agreed SC would present Screening Tool at next meeting.
SMC to provide JW with Autocon contact details.
JR stated that her son had problems with ear moulds having to have 4 sets when moving to adult services, she thanked SMc for resolving the issue.
Date of Next.Meeting
8th June 2021 1pm
……………………………………………………………………………………………………………………………………………………..