Parent-led ear health checks at home for children with complex needs pilot-project: a new approach to improving access to ear health.

Objective: To assess the acceptability of parent-delivered ear health checks at home for children with complex needs.

Design: A multi-method service level evaluation of a modified ear check pathway. Qualitative and quantitative data were collected via interviews, Likert scale questions, and otoscopy and tympanometry acceptance data.

Study Sample: A purposive sample of twelve children with complex needs who had not accepted either otoscopy or tympanometry in their last clinic appointment. This included their parent carers who had agreed to carry out ear health checks within the home environment.

Results: Parents' confidence increased following training for video-otoscopy (10 out of 12) and tympanometry (9 out of 12). More children accepted otoscopy (62.5% compared to 16.7%) and tympanometry (54.1% compared to 12.5%) when delivered at home by a parent, compared to their last clinical setting appointment. Parent/carer responses indicated the service modifications were acceptable, supported partnership working and improved access. Trust and individualisation were important constructs.

Conclusions: Parent carer-delivered ear health checks at home have the potential to provide an alternative approach to reasonable adjustments for children with complex needs, utilising familiarity and enabling flexibility, potentially reducing some of the barriers faced by children with complex needs in accessing services.