G464 National survey of the aetiological assessment service of permanent childhood hearing impairment in ireland

Introduction The Universal Neonatal Hearing Screening programme was implemented in Ireland in 2014. Approximately 100 infants are identified with a permanent childhood hearing impairment (PCHI) each year, an incidence of 1.5/1,000. Best practice dictates that all children who are identified with PCHI should have access to prompt paediatric assessment to determine the need for aetiological investigations. The implementation of the UNHS programme did not include any increased resource for paediatrics thus raising concern regarding timely access to medical assessment. This survey aimed to assess the provision of aetiological assessment services nationally with a view to informing future service development. Methods All paediatricians involved in aetiological assessment were identified from the national audiology lead. A questionnaire was developed using the BAAP standards and was sent by post with email reminders. Results were collated on excel. Results 38 consultants were identified of whom 37 responded. 33 paediatricians reported that they assessed children with PCHI in clinic. Only 6/33 had received any specific training in the assessment of PCHI infants. This work was not included in any job plan and no additional posts had been developed. Only 1 paediatrician reported participating in a regional support network, but the vast majority (92.9%) surveyed expressed an interest in developing a regional network. 5/33 (15%) saw the infants in a dedicated hearing clinic. Waiting time for assessment was beyond the recommended timeframe in all cases, (range 2–52 weeks, average of 14.4 weeks). Only 8/29 (27%) assess by 6 weeks of age, the time limit for treatment of congenital CMV infection. Access to MRI is limited, only 12 (28.6%) reported having access to MRI within 12 weeks of age thus the majority of MRI require sedation. 77% routinely refer all children with PCHI to ophthalmology. Conclusion The above survey highlights significant deficits in the paediatric component of the UNHS. Identified gaps include; inadequate appropriately trained staff and lack of timely access to necessary investigations and tertiary services. A national multi-disciplinary working group has been developed to address the deficits and ensure an improvement in service provision.