Kingdon review of children’s hearing services reveals over 300 deaf children harmed due to audiology errors and makes 12 recommendations

The Kingdon review of children’s hearing services has been released today, revealing that over 300 deaf children were harmed due to errors in pediatric audiology, and making a number of recommendations for the improvement of children’s hearing services.

The review b y Dr Camilla Kingdon, was commissioned by the Secretary of State for Health and Social Care, the Rt Hon Wes Streeting MP, after a series of catastrophic failures were uncovered in paediatric audiology services in some areas of England.

The review states that evidence was found of “systemic failings in children’s hearing services over many years.” It also states that the services were “assumed to be low risk… when in fact it is a high risk service because the consequences of failing to identify deafness in a child are disastrous” because the users are “babies and small children at a critical window of brain development.”

Over 100 audiologists, healthcare leaders, charities educationalists, academics and officials of NHS were spoken to as part of the report, with 450 responses to calls for evidence and two focus groups run with the National Deaf Children’s Society (NDCS) for parents and carers of deaf children.

The key findings of the review, summarised, are:

1. The failed or late identification of deafness has had a profound impact on many affected babies and children, and their families
2. The NHS England Paediatric Hearing Services Improvement Programme that was established in 2023 has not met the target it set for recalling affected babies and children and has lost the confidence of external stakeholders
3. Communication between NHS England and DHSC about the service issues in children’s hearing services did not follow expected practice and there was no dedicated DHSC lead
4. There has been no assurance of quality, as measured by safety, effectiveness and patient experience, in children’s hearing services in England, for some time. Service delivery is highly varied and so it follows that outcomes are unacceptably variable
5. Children’s hearing services are rarely on anyone’s radar – regionally, at ICBand at provider level – nor among regulators, for example the Care Quality Commission
6. The audiology workforce has been neglected for years, their status and profile is low. There is little professional governance and fragmented professional representation. There is a lack of coherent workforce planning and little investment in research
7. The findings of this review are highly relevant to any service which attracts little attention, investment or scrutiny, but has the potential to cause lifelong harm when quality standards are not upheld

There are also 12 recommendations made, including that the role and remit of the current service is reviewed, with a new commissioning framework, that audiologists should be professionally registered, with hearing services delivered by a network model, outcomes and service quality should be monitored, training pathways for children’s audiologists should be reviewed,  research in audiology should be funded at a national level, that hearing services should be setting the standard for deaf awareness,  that action should be taken to improve “workforce culture and morale in children’s hearing services, there should be a structured regional response process to service issues, and that written guidance should be provided for all officials regarding how to raise service issues with ministers.

The review was welcomed by the National Deaf Children’s Society (NDCS), who said it was ‘heartbreaking’ that deaf children and their families have been so badly let down and welcomed that deaf children and their families have been at the front and centre of the review.

George Crockford, Chief Executive at the NDCS said:

“It’s vital that deafness is identified early so that deaf children can be supported right from the start. Repeated failure to do this has had a devastating impact on far too many babies, children, and their families.

“Deaf children and their families deserve far better than an overlooked, undervalued and underfunded ‘Cinderella service’ that doesn’t meet their needs. We welcome the recommendations of this review, which clearly set out what needs to happen to ensure that every child can access high quality hearing services as early as possible. It’s vital that these recommendations now turn into action. This starts with increased investment — building the capacity and skills needed to deliver high quality children’s hearing services for every child who needs them.”

The National Deaf Children’s Society is urging the Government to invest in paediatric audiology services as a matter of urgency. The charity says that this is the only way to minimise the risks and harm from the current failings and lay the groundwork for a more cost-effective, accessible paediatric audiology service in the NHS that is fit for the future. It stresses that deaf children and families must be at the heart of every decision now made to improve services.

Anyone with concerns about their child’s hearing can contact the National Deaf Children’s Society for tailored support at ndcs.org.uk or on 0808 800 8880. The charity’s Early Intervention Advice and Guidance Officers provide specialist one to one support for families of newly identified deaf children and those preparing to having their child’s hearing retested through recall. Contact the team at adviceandguidance@ndcs.org.uk.