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In late 2021, the British Academy of Audiology (BAA) released a report following their review of the standard of care provided by NHS Lothian Paediatric Audiology services. For many, this report flew under the radar; missed among the countless other negative stories which have filled our news reports over the past couple of years.

At the same time, for many others, this report brought to light the very issues they feared. It is a parent’s worst nightmare for their child to receive medical care which falls below the standard to be expected, and for their child’s health and wellbeing to suffer as a result. The BAA report confirmed that, for a great number of families in the Lothians, that nightmare became a reality.

Although the report was released late in 2021, the process which led to its conclusions had been ongoing for some time. Following a complaint to the Scottish Public Services Ombudsman (SPSO) regarding treatment provided by the Audiology Service at NHS Lothian, various recommendations were made to the Health Board by the SPSO. In order to comply with these recommendations, the BAA was commissioned to carry out an audit of the care provided by the department in question.

The audit itself was extensive: it reviewed the Health Board’s Paediatric Audiology case-load between 2009 and August 2021, the time period covered highlighting the significance of the situation. Over 22,000 children received treatment over this period, and a sample of those cases were reviewed by the BAA.

The results of the audit were damning. It found that since 2009, none of the British Society of Audiology or Newborn Hearing Screening Protocols had been followed. As a result of the failures found in the Health Board’s practises, it was advised to stop Auditory Brainstem Response (ABR) Testing immediately, in September 2021. The Health Board agreed to do so, and children were instead sent to a neighbouring Health Board.

The BAA report identified a number of serious and significant issues in the care provided, particularly within the under 5 age group of the Paediatric Audiology service. Of particular note, the BAA suggested that the root causes of the service’s problems were:

  • Inaccurate in-house training of staff with no form or external competency assessment
  • A lack of sufficient scientific leadership, knowledge and enquiry
  • A lack of routine and robust quality assurance processes using hard evidence to assess quality and monitor the service.

At the conclusion of the audit, the BAA made 36 further recommendations to improve the Paediatric Audiology Service to ensure it is both safe and fit for purpose in future.

Whilst improvement in practices and the quality of service provided is, of course, a positive step and a welcome development for families presenting with their children in future, this does not repair the damage done to those who attended between 2009 and 2021.

Unfortunately, the children affected by the service’s failures have been severely impacted. A number of children with hearing loss at birth have been denied access to appropriate hearing aid management. Whilst the average age of diagnosis across England in 2018 was 109 days, the average at NHS Lothian was a massive 1,653 days. Whereas children in England could expect to be diagnosed within 4 months, children under the care of NHS Lothian were often well past their 4th birthday.

Delayed diagnosis and misdiagnosis of hearing loss, particularly in early years, can have a profound and often irreversible impact on a child’s life and life prospects. The parents of those children who were let down by the service during this time are now rightly demanding answers and deserve assurances that everything possible is being done to help their children.

Accordingly, any child who has suffered because of the poor treatment provided by NHS Lothian Audiology service may be entitled to appropriate compensation. In my role within the Medical Negligence department at Thompsons Solicitors I have already been instructed by a number of affected families. If you wish to discuss the treatment provided to your child during this period, please get in touch.

Blog by Jonathan Howat, Associate Solicitor



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