AGENDA FOR CHANGE
NHS JOB EVALUATION SCHEME
1. JOB IDENTIFICATION
Job Title: Senior Audiologist
Reports to Head Of Audiology Services
Department Audiology
Surgical directorate
Job Reference:
SSSARAIGAUDI07
No of Job Holders: 1
Last Update 19/02/2015
2. JOB PURPOSE
A practicing healthcare Practitioner, who contributes towards the management and provision of a
comprehensive Audiology Service in Raigmore Hospital and community clinics.
This involves children of all ages, comprehensive rehabilitative care, complex diagnostic assessments of
hearing, and care for adult hearing aid users, and their carers/relatives.
Works independently in the main with supervision if required.
Demonstrates effective communication and interpersonal skills with other professionals and service users,
including patients, carers and relatives.
Maintains professional standards.
Maintains patient and departmental records both written and electronic using computer databases and
word processing.
Provides clinical assessments and hearing aid programming and provision using complex computer
software and specific specialised hardware.
Contributes to the development of services in the clinical areas that the post holder works in Raigmore
hospital.
Development of the balance service and the adult screening service.
3. DIMENSIONS
Operational
This post holder works within the paediatric team mainly, with some input into the adult Audiology team
The whole service Provides a high quality newborn hearing service to babies in the remote and rural areas
who have not been screened at birth.
Complex diagnostic assessments on Adults, children and neonates.
Provision of a high quality hearing aid service for Adults and Paediatrics to best practise standards.
Training and teaching of Medical students and Audiology students and practitioners at all levels, junior
medical staff and other professional groups.
Delivers a comprehensive Audiology service, including direct referrals for hearing aids, hearing aid
provision and management, diagnostic assessments both routine and complex for Ent and Tinnitus
patients
A minimum client base of approximately 30000 regular hearing aid users, plus other service users.
Annual activity of over 19,000 contacts.
.
Staff
The post holder has no line management duties within the paediatric and newborn hearing screening
services, except if there are students or junior Audiology staff working in the same paediatric clinics.
The Audiology services workforce of WTE made up of 18 staff in total. 4 of these are for the separate
newborn hearing screening service.
Financial
This post holder maintains own stock levels and advises senior staff of what to purchase and if stock is
low.
4. ORGANISATIONAL POSITION
See attached sheet
5. ROLE OF DEPARTMENT
The Audiology department provides a diagnostic, hearing aid and rehabilitation service to any person or
professional that requires it in the Highlands Health board area.
A technical support service is also provided at Ent clinics. It also provides a newborn hearing screening
service to all babies born in the Highlands.
To achieve this, the Service:

Provides hospital based specialist investigative and diagnostic services to 5 ENT consultants and their
middle and junior grade medical colleagues. This includes complex and non-routine electrophysiological
measurement testing to assist in the diagnosis of hearing and vestibular disorders associated with
ENT/neurological and audiological complaints. Testing is undertaken on an outpatient and in-patient basis
within the Audiology Department and ENT theatre sessions.

Delivers an assessment and rehabilitation tinnitus service to tinnitus sufferers.
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On a daily basis provides audiology input to assist in the running of all routine ENT outpatient clinics.

Works in partnership with ENT in the provision and development of the Bone Anchored Hearing Aid
Service and the Cochlear Implant programme.

Delivers a Universal Newborn Hearing Screening Programme.

Delivers diagnostic testing and all follow up hearing aid related activity as necessary, to the Organisation’s
Newborn Hearing Screening Programme as part of the National Programme.

Works in partnership with the Education Department to provide a continuous programme of assessment to
deaf and hearing impaired babies and children including pre-school, special schools for children with
learning disabilities, mainstream schools and specialist hearing impairment units attached to mainstream
schools.

Provides assessment, selection, and prescription fitting of hearing aids to all residents the Highlands from
newborns to the elderly to include the development of individual care packages and lifelong support and
rehabilitation.

Operates a direct GP referral system for hearing assessment leading to hearing aid provision thus relieving
ENT OPD sessions from significant pressures and devolves responsibility from ENT Specialists to Senior
Audiologists also shortening the referral to appointment time for patients.

Provides a service 5-days a week for hearing aid repair and/or battery exchange from all sites to all preexisting Highland NHS hearing aid users.
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Delivers training and education to departments and agencies out with the Audiology Service i.e. medical &
nursing staff, voluntary organisations, public sector staff, and business community etc to promote the
issues faced by the hearing impaired and provide on occasion practical training in dealing with these and
the technical issues associated with the use of hearing aids.

Liaises closely with other professionals within Health, Education and Social Services across the 3 local
authorities in addition to the private sector and volunteer groups to maximise the provision of care for the
hearing impaired.
The department provides an Audiology Service in line with Scottish Executive Health Service Quality requirements,
the local health plan and national objectives. (Modernisation and Universal Newborn Hearing Screening) as well as
adopting the principles and practices of Employee Friendly Policies and Staff Governance.
6. MAIN TASKS, DUTIES AND RESPONSIBILITIES
Clinical:
1. Collaborates with the Audiology Manager in the provision of specific clinical work on a daily
basis, ensuring an efficient and effective service within clinical governance guidelines.
 Maintains professional standards and protocols without supervision.
 Responsible for maintaining own workload, prioritising referrals, arranging follow up
appointments agreed with patient and arranging relevant clinics/planning. Contact with clients
within hospital clinical settings.
2. To perform and analyse diagnostic assessments of hearing on adults, children and neonates.
 Using air conduction headphones and bone conduction vibrator to obtain accurate hearing
threshold levels (using masking stimuli where appropriate) and following British Society of
Audiology guidelines. Instructing the patient on what is required of them to perform the test
including the use of tact and persuasion where barriers to understanding exist e.g. children
with special needs, adults with learning disabilities, babies and the patient may be uncooperative.
 Perform middle ear analysis using tympanometry, including probe microphone insertion to
determine the function of the middle ear; acoustic reflex testing and eustacian tube function
tests. As part of the test battery for further management of medical conditions.
 Perform examination of the ear using clinical Otoscope in order to identify healthy and
abnormal ear conditions. Recognising contra-indications to performing further procedures and
appropriate referral to other professionals (ENT, GP, Specialist ENT Nurse) for
management/treatment where required.
3. Selection, Verification and Programming (subjective and objective) of hearing aids on adults and
children of all ages.
 Using assessment results to select and programme appropriate hearing aids using specific
computer software and hardware tools.
 Assess patient’s individual, physical abilities and social needs in choice of aid and programmes.
 Verify the hearing aid programming using subjective (free field and verbal assessment) and
objective ‘Real Ear Measurement’ or ‘Real Ear to coupler Difference’ (on children) techniques
involving insertion of probe tube microphone into the ear canal. Making adjustments to
prescription of hearing aid as appropriate. Involves fine manual dexterity and care, requiring
prolonged concentration.
4. Provides comprehensive and complex rehabilitation and counselling:
 Instructing patient/or parent/carer on effective use of aid, communicating realistic expectations,
advice on the disabling effects of hearing loss. Using basic directive counselling and empathic
skills to empower the patient/parent/carer in their rehabilitation and management of hearing loss.
 Formulating individualised care plans.
 Using effective communication and persuasion where a poor motivational attitude to hearing loss
may exist and barriers to understanding and communication may include hearing loss, visual
impairment (including deaf-blind clients), dementia and stroke patients with aphasia, and patients
with learning difficulties.
 This will also include fitting hearing aids to small children where a high degree of specialised skill
is required.
5. Audit and outcome measures: Further training is being done in this specialised children’s area.
 Audit the benefit of hearing aid use and patient satisfaction using nationally recognised benefit
profiles for children and questionnaires. Input the information into software packages.
 Using the outcome measures for further rehabilitation measures.
 Take part in clinical audit, and research & development of the activity of the service to improve
patient services.
6. To maintain children’s hearing aids:
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Dealing with maintenance and replacement of faulty hearing aids, supply of batteries, retubing of earmoulds.
Dealing with queries and problems presented by patients/parents and carers and referring them
to the appropriate professional if required.
Inpatients are seen pre-operatively and post-operatively.
7. Modification of earmoulds for patients using appropriate equipment (with training) including dental
drill, buffer/grinder and safety equipment, to ensure comfortable and acoustically viable fit.
 For adults, preschool and school age children and patients with special needs with all types of
hearing aids requiring skill, dexterity and judgement when working to finer tolerances.
8. To take accurate and safe impressions of the ear:
 On adults, neonates, pre-school and school age children and children and adults with
learning difficulties.
 Taking impression of the ear following professional recommended procedures (BSA) by
placing foam otostop into ear canal, then syringing impression material into the canal to


form an accurate impression for processing by the earmould manufacturer.
Determine the type, material and any modifications required for earmoulds, swim moulds
and other types of earpiece required (e.g. ear defenders).
Ensures the prompt processing of ear moulds and hearing aid repairs
9. To take a clinical lead in the following specialist areas being responsible for generating written, verbal
and electronic reports to other professionals, communicating results, prognosis and further actions:



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Diagnostic Audiology on adults and children including: 1. Assisting in auditory brainstem
response assessments using electrodes to detect stimuli form supra aura/intra aural headphones and
bone conductor, and using specific computer software and hardware. 2. Otoacoustic emissions to
detect cochlear function using probe microphone and specific computer software and hardware. 3.
Using speech tests with children and adults such as SIN, AB tests, toy tests, using words and
headphones to determine speech discrimination. 4. Balance tests.
Paediatric Audiology: routine assessment of neonatal to pre-school children. Using persuasion
and encouragement strategies to elicit co-operation and responses from children and babies who
may be reluctant to participate, using a variety of age-related assessments including distraction,
performance, co-operation tests, VRA (visual response audiometry), OAE (Otoacoustic
emissions), and tests of middle ear function using tympanometry.
Supervision and training of Assistant Audiology Practitioners, Associate practitioners and hearing
screeners.
Ensure annual calibration of own equipment is carried out, equipment sent for repair to
appropriate department/company.
Hearing aid stock control: paediatric hearing aid stock maintenance to ensure adequate levels of
stock for new issuing and replacement. To appraise the Audiology manager and Lead Audiology
staff if stock levels are low.
Direct referral hearing aid clinic: taking accurate clinical history, otoscopic examination of the
ears, performing diagnostic assessment and making a clinical decision on the appropriateness of
hearing aids and assistive listening devices, formulating a patient management plan. Reporting
findings to GP and other medical personnel as required for further management. (This post holder
occasionally performs this).
Assist in development of an adult screening programme in NHS Highland.
10. Demonstrating effective interpersonal skills when dealing with staff, patients, relatives and the public
in person, on the telephone and in writing.
11. Take a role in the risk assessments of the department with the senior staff.
12 Administrative duties will include:
 Maintenance of accurate and efficient patient records both paper and computer databases.
 Records clinical test results and observations onto electronic patient database and hospital patient
management system.
 To assist in maintaining accurate and efficient records of all technical services, including
computer databases and stock control functions.
MANAGEMENT AND OTHER
1. Report any deficiency in health and safety systems or documentation to own line manager of area
concerned.
2. Attend Occupational Health for health surveillance/vaccination following accidents and for
monitoring as laid down by Trust policies.
3. Co-operate with and attend training provided for health and safety purposes.
4. Attend annual mandatory training in line with Trust Policy.
5. Implement new or revised Trust and departmental Policies and contribute ideas to, for change to
increase efficiency and effectiveness of the department inline with clinical governance guidelines.
6. Follow professional and departmental procedures; proposes changes to procedures for own
working area; contributes comments on proposed changes to procedures; contributes to the
development of procedures and service for own working area.
7. Assisting Lead Audiology staff with service audits such as DNA’s at outreach clinics
8. To participate in a yearly performance and development plan
9. Actively participate in staff meetings and training programmes
7a. EQUIPMENT AND MACHINERY
a. The main Audiology database is Auditbase and the post holder is fully competent in all aspects of
its use.
b. Laptops and computers are routinely used and attached to this software by the post holder.
Most of the post holder’s day would be involved with this database and associated equipment and
software. Statistics and scheduling are all developed on the database.
c. All digital and analogue hearing aids are computer programmed by the above software and stored
on the main server.
d. The Auricle audiometers, which test peoples hearing, are also attached to the above.
e. The auricle real ear measures to make sure that the hearing aids are fitted correctly are also
routinely used
f. The auricle test box is used routinely to check the output, frequency and gain of hearing aids.
g. Stand alone audiometers are also used
h. Label printers and DeskJet printers are also used on a daily basis.
i. Otoscopes are routinely used to assess if there are any medical conditions in the ear that might
prevent assessment or treatment.
j. Speech words are presented to patients for them to repeat by the use of the Aurical software.
k. Speech testing equipment is also used with children
l. Tympanometers are used regularly to check pressure of the middle ear and assess for middle ear
disease.
m. Specialised hearing aids such as Bone anchored ones are maintained by this post holder.
n. Drills and grinding equipment for maintenance of patients earmoulds
o. Word processing and spreadsheets
p. Visual Reinforcement audiometry is performed with speakers and reward boxes to test small
babies and children routinely.
q. Syringes for inserting impression material into the patients ear
r. Otoacoustic emissions
s. Era equipment
t. Paediatric hearing aid equipment and hearing aids
u. Otostops for ensuring safe removal and insertion of the above
v. Balance testing equipment.
7b SYSTEMS
Auditbase
Intranet
Email
Maintaining and updating patient records
TRAK queries through database
Populating databases
Hearing Aid Software
8. ASSIGNMENT AND REVIEW OF WORK
Referrals to this post come from the Lead Adults and Paediatric audiologists, Ent Consultants, GPs,
speech and language therapists, health visitors, paediatricians, neonatal referrals from other health board
areas, Deaf Services and Hearing Support teams, voluntary services and other Audiology staff.
Work is reviewed by the Head Of Service through the dept database as a monthly audit on all patient
contacts by all staff and yearly personal development plan.
Policies and procedures and good practise standards are available but post holder varies these with
discretion for individual patients.
When performing the clinics work is unsupervised all the time, with guidance, if required.
9. DECISIONS AND JUDGEMENTS
Decides on patients hearing test results and planning the appropriate care for them – fitting
the most appropriate aid for their lifestyle/educational situation with noise adaptation programmes for
when they are in background noise.
Also taking into account any additional disabilities such as visual, mobility problems,
communication disorders and special needs and constantly reassessing the patient’s abilities throughout
their life.
Deciding if the patient requires referring on to the Ent Services (this is for tinnitus, dizziness, pain,
discharge or asymmetrical. hearing loss). Sometimes there will be conflicting results and patient history.
Deciding to refer on to social services for additional support such as visual alerting fire alarms.
Deciding to refer onto education, Speech and language and Therapists and paediatricians.
Deciding which hearing aid to fit when there are lots on the market, particularly paediatric fittings as
the choice are large.
Deciding if one ear or both ears should be wear a hearing aid
Deciding which ear mould to fit (there are hundreds of different types including non allergic and
Gold plated to chose from.)
10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB
Communicating with very young children with no speech and possible hearing loss and often added
disabilities such as autism, and their parents or carers.
Persuading and motivating children and their parents to accept and wear hearing aids
If there is no senior staff in Raigmore-has been called upon to run the dept on occasions.
Dealing with very difficult IT problems.
Accessing computer to work from when no workspace has been supplied
Keeping up with latest technology, training, particularly in large range of paediatric hearing aids etc due
to remoteness of Inverness.
11. COMMUNICATIONS AND RELATIONSHIPS
Communication
Most communication is face to face. A great deal is by email and by telephone.
1. Ent Consultants about audiological/ ENT problems with individuals.
2. Audiology staff on a daily basis about clinical and managerial items.
3. Ent Nurses about individual patient care.
4. Clerical staff about organisation of clinics and appointments.
5. Lead Paediatric audiologist/ Head of Audiology concerning personal development,
day to day concerns
6. Hearing screeners
7. Users of the Audiology service both face to face and on the telephone. Much of the work with
the Paediatric Audiology patients/parents/carers requires tact, sensitivity and persuasion.
There are often difficult issues with the families that are attending Audiology such as child protection
and confidentiality issues.
8. GPs – reports on individual patients are sent to GPs.
9. Deaf education Services
10. NDCS – local highland branch
11. Community Paediatricians
12. Maternity and SCBU nurses
13. Parents, carers and patients- explanations of complex results and rehabilitation strategies in
Patient friendly and sensitive way
The most difficult part of these communications is to react to different situations.
This post holder has to be responsive to many different situations during the day keeping calm and
patient with small children, in a hectic Paediatric Clinic schedule.
12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB
13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB
Scientific knowledge acquired through formal training to BSc Audiology or equivalent (i.e. HNC in
physiological measurement + specialist courses and BAAT part I and II) plus knowledge of specialist
procedures acquired through accredited courses or equivalent experience to post graduate or diploma
level.
State registration with the Royal College of Clinical Physiologists is required
Further training in children’s paediatric Audiology courses, including diagnostic ERA.
Child Protection courses
Advanced programming of Children’s hearing aids
Advanced IT skills
14. JOB DESCRIPTION AGREEMENT
I agree that the above Job Description is an accurate reflection of my duties and
responsibilities at the date of signing.
Job Holder’s Signature:
Date:7/09/05
Manager’s Signature:
Date:7/09/05