Guidance

7. Data and reports

Updated 10 October 2024

Applies to England

Screening data

High quality data collection and performance monitoring is important to the success of newborn hearing screening. If the data is inaccurate or incomplete there is a real risk that a baby with a hearing loss could be missed and data reports will not give a true reflection of provider services.

The local programme manager has responsibility for carrying out regular data quality checks and audits to make sure data is complete and accurate. The national IT system enables data to be presented in fine detail about individual services, screeners or patient records. Review and analysis of all reports provides a detailed picture of local screening services to help identify and inform quality improvement initiatives. This review should be undertaken on a regular basis.

Detailed guidance on local programme management tasks will support the local manager and local providers to quality assure and performance manage their NHSP service overall as well as monitor activity for individual screeners.

NHSP programme standards and key performance indicators (KPIs) set out the expectation for programme performance.

Data reports are available to local managers from within the national IT system and programmes are responsible for saving their reports locally.

Child health organisations are responsible for making sure newborn hearing screening results are recorded in the child health system.

Read-only access to the NHSP national IT system SMaRT4Hearing (S4H) enables designated child health department staff to view records for their responsible population and export screening results for reporting purposes.

National hearing screening IT helpdesk

Email S4H.helpdesk@nhs.net

Phone 0845 0130183

For users of the S4H IT system. The helpdesk is open from 7am to 7pm, 365 days a year.

National reports

The national NHSP programme produces an extensive collection of reports for providers and screening quality assurance service (SQAS) teams on a regular basis to demonstrate:

• performance
• highlights
• activity
• outcomes
• data quality

Programmes are responsible for reviewing their reports and taking appropriate action where necessary. See national reports summary table for details of the reports that are available.

Information should be shared as appropriate with the local hearing screening team, audiology services, governance groups, commissioners and SQAS.

Performance reports

Performance reports 1, 2 and 3 – programme standards and KPI reports

Purpose: Enable performance monitoring and reporting of programme performance within provider units and to commissioners.

Performance report 4 – KPI NH1 not achieved

Lists all records which breached the NH1 timeframe.

Performance report 5 – KPI NH2 not achieved

Lists all records which breached the NH2 timeframe.

Purpose: Enables investigation of KPI breaches, to identify patterns and enable improvements in achieving KPIs

Performance report 7 – external quality assurance (EQA) funnel plots

Purpose: produced for SQAS. To demonstrate performance and rate of yield for each local service against national standards and KPIs. Presents data for all sites in the form of funnel plots to enable identification of programme performance and identify where quality improvements are required.

Highlight reports

Highlight report 1 – well babies with clear response without supporting screening tests

Purpose: identifies well babies who have been given screen outcomes of clear response, no follow-up or clear response targeted follow-up where the results on the national IT system do not justify these outcomes.

Highlight report 2 – neonatal intensive care unit (NICU) babies with screen outcome of clear response without supporting automated auditory brain response (AABR) test results

Purpose: identifies well babies who have been given screen outcomes of clear response, no follow-up or clear response targeted follow-up when the results on the national IT system do not justify these outcomes.

Highlight report 3 – imported test results changed from no clear response or not complete to clear response

Purpose: alerts programmes to records where an imported test result from the screening equipment is no clear response and the test result in the national IT system is clear response.

Highlight report 4 – imported test results differ: other discrepancies

Purpose: alerts programmes to test results changed by the user on import to the national IT system.

Highlight report 6 – test method of entry different from screening equipment data quality (SEDQ)

Purpose: identifies test results entered on the national IT system using a method of entry other than SEDQ.

Highlight report 9 – referrals with estimated gestational age (GA) at birth less than 21 weeks

Purpose: alerts programme to records with GA of less than 21 weeks (GA is required for the calculation of the NH2 KPI).

Highlight report 10 – test results assigned to unknown screener

Purpose: alerts programmes to tests assigned to an “unknown screener” on the national IT system. NHSP guidelines say no activity should be assigned to generic usernames.

Highlight report 12 – over 90 days old (corrected age) and screening outcome – pending in process

Purpose: report lists records for babies over 90 days old (corrected age) and screening outcome pending – in process. Legacy data is excluded from this report.

Highlight report 13 – clear response QA1 cavity check

Purpose: report lists occurrences of clear response for quality assurance 1 (QA1) cavity check, for programmes to investigate.

Activity reports

Activity report 1 – monthly basic

Purpose: to monitor activity by reviewing all records for which they have carried out any screening testing, irrespective of the current location of the record. The report can also be used to monitor the number of attempts at each protocol stage by a screener.

Activity report 2 – monthly extended

Purpose: as above basic version but contains additional detail for each record.

Activity report 3 – transfers in

Purpose: to monitor activity. Details all records created in other programmes and transferred into the local programme.

Activity report 4 – transfers out

Purpose: to monitor activity. Details all records created in the local programme and transferred to other programmes.

Activity report 5 – discharge report

Purpose: to monitor activity. Details the location and outcome of screening activity for records created within the local programme.

Activity report 6 – protocol adherence

Purpose: to monitor that the screening protocol is being adhered to.

Activity report 7 – by screener

Purpose: to monitor screener activity. Details the number of clear responses, no clear response and not completes during the last month including the number of well baby or NICU babies screened and the number of AABRs which are performed.

Activity report 8 – by health visitor

Purpose: to monitor screener activity for community-based programmes. Details the number of clear responses, no clear response and not completes during the last quarter including the number of Well baby or NICU babies screened and the number of AABRs which are performed by each health visitor (screener).

Activity report 8 – by health visitor

Purpose: to monitor screener activity for community-based programmes. Details the number of clear responses, no clear response and not completes during the last month including the number of Well baby or NICU babies screened and the number of AABRs which are performed by each health visitor (screener).

Activity report 9 – national

Purpose: Allows comparison of local screener activity against national data. It may indicate variations in practice but should not be used as a target or standards report.

Activity report 10 – screener by outcome

Purpose: to monitor the number of unilateral or bilateral referrals by each screener.

Outcome reports

Outcome report 1 – screen referral and yield

Purpose: provides a summary report of all data currently in the local programme. The report provides sufficient detail to inform and enable audit of records locally.

Summary information includes:

• total records currently in the local programme with a screening outcome
• total records currently in the local programme that have a referral screening outcome of:
  • no clear response – unilateral referral
  • no clear response – bilateral referral
  • incomplete – baby/equipment reason (historic records)
  • incomplete – screening contraindicated
  • incomplete – baby unsettled
  • incomplete – equipment malfunction
  • incomplete – equipment not available
• follow-up status for direct screen referrals
• yield estimates for direct screen referrals
• yield estimate for screening outcome of “clear response-targeted follow-up”
• yield estimate for all other screening outcomes
• total yield
• severity breakdown for all cases of bilateral permanent childhood hearing impairment (PCHI)
• patient details for all records with PCHI (including AN/AD, now known as ANSD) including those not directly referred by the screen
• important information for each record and indicates for each record which yield estimate(s) it contributes to, including those not referred by the screen

Outcome report 2 – permanent childhood hearing impairment (PCHI) audit

Purpose: to audit all records that have ever been included on the PCHI register in the past but are no longer on the register.

Outcome report 3 – auditory neuropathy spectrum disorder (ANSD) audit

Purpose: to audit all records that have ever had a type of hearing loss set to AN/AD, now known as ANSD.

Data quality reports

Audiology data quality report 1

Purpose: to address essential missing data from bilateral PCHI records.

Audiology data quality report 2

Purpose: to address essential missing data from unilateral PCHI records.

Audiology data quality report 3

Purpose: to identify active records that need audiological assessment updates.

Further guidance on management of babies within NHSP services and their data is available in guidance notes for local programme management tasks.