Cochlear implant services for children, young people and adults. Quality standard

Figures & data

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Quality statements
1. CI devices used comply with all UK/EU regulatory frameworks as appropriate and local organisational policies
2. The procurement process allows consideration of quality, effectiveness and reliability, clinical and long-term support, as well as cost

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3. Candidacy criteria adheres to current NICE guidance

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4. Each CI centre will appoint a Mentor to liaise with local CI Champions

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5. The CI clinical team is multidisciplinary including a clinically-experienced Service Lead
6. All CI professionals comply with their professional organisation’s regulations and guidelines

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7. Patients/families/carers have access to current relevant information complying with the NHS Accessible Information Standard
8. Communication needs are met for direct patient contact across the whole care pathway

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9. The CI service commits to and evaluates equality of access to care, and demonstrates plans and actions to address areas of inequality identified

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10. The CI service provides comprehensive service delivery across the care pathway to ensure continuity of care
11. Service flexibility ensures person-centred care
12. Services support and empower patients to self-manage their cochlear implant care
13. The CI service adheres to current NHS waiting time directives
14. Protocols are in place to expedite time-sensitive cases

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15. Assessment includes medical, audiological and rehabilitation components
16. The assessment results and recommendations of the team are communicated effectively
17. Decision regarding future clinical management is taken by a multidisciplinary team in collaboration with the patient/family/carer

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18. The CI surgery is undertaken in a clinically safe environment
19. The CI service has a minimum of two experienced CI surgeons
20. Surgeons maintain high levels of skill and experience evidenced by regular clinical audit
21. Surgery is carried out using minimally invasive techniques
22. Facial nerve monitoring is used
23. Surgery under local anaesthetic is available
24. Device function testing is available
25. Appropriate peri/post-operative imaging is available
26. A written report is sent to the GP following surgery
27. Written information is given to the patient or parent/carer on discharge from hospital

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28. Programming is performed in line with manufacturers’ recommendations
29. Instructions and supporting materials on the handling, operating and care of the sound processor are accessible to the patient or parent/carer on or before the day of first fitting
30. Appropriate programming schedules are set according to each patient’s individual needs
31. Rapid access to appointments is available for cases of urgent clinical need
32. Appropriate management is available for patients with residual hearing in the ipsilateral ear (hybrid/EAS) or contralateral ear (bimodal)

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33. All patients are offered person-centred rehabilitation. This will optimise device use and listening to support individual communication goals and quality of life
34. The patient’s family and support networks are included with patient/parent permission
35. Staff maintain close links with local services to offer support and advice at all stages
36. The rehabilitation team has appropriate expertise and skill mix to identify and advise on coexisting issues that may impact listening

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37. CI services provide the essential sound processor equipment for patients, and ensure access to essential consumables either directly or through manufacturers’ support services
38. Replacement equipment is provided to patients in the UK within 2 working days
39. Patients will use their sound processor model for at least five years, after which an upgrade is offered if it provides improvement
40. CI services ensure patients are aware of the importance of CI site skin health
41. CI services ensure patients are aware of the risk of harm from battery ingestion and use secure battery compartments when required

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42. Suspected device failure is treated as a clinical priority by the CI service and the manufacturer. Device function test results are confirmed by the CI manufacturer within 7 days of their assessment
43. Replacement surgery is carried out as soon as possible
44. The manufacturer provides a detailed report of the failure analysis of the explanted device within 3 months of receipt
45. The CI service reports all device failures to the relevant statutory body
46. Patients are informed of the MRI compatibility of their device and will be told to contact their CI centre if they are referred for an MRI scan

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47. People with CI remain under the care of a cochlear implant team for life
48. Individual outcomes are monitored and inform the ongoing treatment plan
49. Written reports are sent at appropriate timepoints to the patient/parents/carers and relevant professionals as clinically appropriate
50. Service audits are undertaken to demonstrate continuous service improvement and compliance with relevant commissioning policies
51. CI services contribute to the BCIG-led annual data collection
52. Annual patient satisfaction survey/s are undertaken
53. Services are committed to evidence-based care and decision making

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54. Services comply with data collection and upload requirements of the NRHI when available

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55. Changes to practice are co-designed with patient representative groups as appropriate
56. Feedback from patients, referrers and the public is considered, and shared with BCIG as appropriate

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57. The CI service has appropriate facilities and equipment for their patients in accordance with national standards and recommendations
58. Audiological testing is performed in sound-treated accommodation to current British Standards
59. Equipment is calibrated and serviced in accordance with current British and ISO standards, with records appropriately retained
60. Medical equipment is maintained and stored according to NHS guidelines
61. All staff comply with infection control and health and safety policies
62. Clinics have a Wi-Fi network that patients can access
63. All staff are appropriately trained on use of equipment required to undertake their duties

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64. Staff comply with their organisation’s staff appraisal scheme
65. Clinical staff meet required professional registration requirements
66. Staff are educated in Deaf Awareness
67. New staff are appropriately trained and mentored

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68. Staff within the CI service are actively involved in educating others in appropriate aspects of cochlear implantation

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69. The CI service complies with all Clinical and Information Governance requirements of their organisation
70. The CI service has appropriate data sharing agreements in place with each CI manufacturer

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71. Managers and service leads commit to a research-positive culture