Kingdon Review lands on profession long demanding better leadership of audiology services

The Government has published an independent review of child audiology services in England that reveals errors amounting to a “disaster” for affected families. The document also highlights long-overlooked issues for the hearing health profession under NHS control, and warns that delays in fixing leadership errors means children’s hearing loss will still be missed, “their life chances forever changed”.

Even before the official publication of the Review on Monday November 10, its chair, leading paediatrician Dr. Camilla Kingdon, was calling in an interview in The Sunday Times, for NHS leadership changes. “It needs a different set of people to be leading it,” said Kingdon.

The Review has been wholly welcomed – but with alerts against complacency – by UK bodies involved in care and support for people with hearing loss, including the British Academy of Audiology (BAA), the Royal National Institute for Deaf People RNID), and the National Deaf Children’s Society (NDCS).

The Kingdon Review clearly has relevance beyond child audiology, definitely in regard to adult services provided under much of the same infrastructure, workforce, and governance as paediatric audiology. It calls for urgent action across 12 key recommendations, including modern commissioning frameworks, improved governance, and a networked model of care to replace isolated service pockets. It has implications for the whole of audiology in England, in particular the call for all audiologists to be registered on a single professional register – with linked improvements in training and CPD.

Audiology – the “Cinderella” service

Kingdon’s indignation at finding audiology treated as a “Cinderella” service is shared by the professional bodies and charities. But the pain for professionals and their guidance organisations is undoubtedly greater on confronting the factual highlighting in the Review that “nearly 300 children have been harmed”, with recall of patients to identify harm still ongoing in some areas. The pantomime simile introduced by Kingdon validly extends to those who have watched and shouted “it’s behind you” without seeing the bad stopped. Just so, BAA President Claire Benton declares in an Academy statement on the Kingdon Review: “This report echoes what audiologists have been saying for years. We now need rapid completion of the review and recall, modern commissioning with clear safety and experience KPIs, a single professional register, and clinically networked services so no clinician is left isolated, and no child is left behind.”  The BAA statement includes lengthy comments on its work towards meeting each of the 12 Kingdon recommendations.

Going back for years prior to the Kingdon Review, similar concerns have been identified in children’s hearing services across Scotland. A 2021 review by the British Academy of Audiology (BAA) found “significant failings” in NHS Lothian’s paediatric audiology service. This led to a Scottish Government-commissioned Independent Review of Audiology Services in Scotland, published in the summer of 2023. Time has passed. The leadership failures now highlighted by this new Review are long overdue. More patients are likely to have been failed.

Thanking Kingdon for her Review, and calling the failure “unacceptable”, Wes Streeting, Secretary of State for Health and Social Care, said in a public letter: “As a priority, I have asked NHS England to work to address issues with the Paediatric Hearing Services Improvement Programme. It is vital we work at pace to minimise the potential harm to babies and children from these service failures.”

Streeting said “a full and considered response to all of the recommendations” would be published “as soon as possible”.

“I would like to assure you that we fully understand the importance of getting it right for children’s hearing services and for other important services that do not receive the attention they deserve. I am determined to make sure this never happens again,” his letter concluded.

The RNID, which says its own report, Still Ignored: the fight for accessible healthcare 2025 policy report England, is still being ignored, also welcomes the Kingdon Review.

“Children and adults across England with hearing loss have been let down by the NHS. By treating audiology as a Cinderella service, the NHS has devalued the impact that hearing loss on an individual’s quality of life,” says the RNID, continuing: “The Kingdon Review must be a wake-up call to the NHS. By setting in place the national leadership and oversight that audiology requires the DHSC can set in motion a transformation in the national hearing health.”

George Crockford, CE at the National Deaf Children’s Society, 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.”

Crockford added: “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.”

Sources: YouGov/RNID/BAA/NDCS/The Times