The British Academy of Audiology Independent Review into the Paediatric Audiology Service at NHS Lothian has found systemic failings which led to some babies and children being undiagnosed or significantly delayed in diagnosis and appropriate treatment.

The Independent Review was requested by NHS Lothian Health Board, in response to the recommendations of the Scottish Public Services Ombudsman report, published in May 2021. The BAA was commissioned to
undertake an independent clinical audit and governance review of the services at Lothian NHS Paediatric Audiology.

The audit was completed by an Independent Review Panel of twelve professionals from England, Scotland and Wales, with significant knowledge and expertise in Paediatric Audiology. The governance review was completed by two senior leaders in audiology and governance. The audit of the Health Board’s Paediatric Audiology case load covered 2009 to 2018, with some areas extended to include patients up until 31st August 2021.

Audit findings identified a series of serious issues particularly within the early years (under 5) age groups of the Paediatric Audiology service. These have led to significant failings, adversely impacting the early years spoken language acquisition of numerous children, affecting a number of these children for life.

The root cause of these failures were a lack of scientific leadership, knowledge, reflection and enquiry in the presence of a lack of routine and robust quality assurance processes.

Recommendations for improvement
The Review Panel recommendations are extensive, with 36 recommendations to improve the Paediatric Audiology Service to ensure it is both safe and fit for purpose. The BAA is supporting NHS Lothian Health Board implementing the recommendations from the review.

The Governance Review team, whilst offering many recommendations for improvement, also emphasised that the NHS Lothian Paediatric Audiology team are friendly, hardworking and supportive of each other. They are keen to offer the best service they possibly can to children within the area. The department has a clear structure of roles and responsibilities, with evidence of regular team and multidisciplinary meetings and
evidence of good communication both internally and with other departments.

Departmental facilities were found to be good, with excellent new soundproof facilities. Many elements of good practice were seen during clinical observation and most appointments and audiological procedures were carried out in accordance with appropriate guidelines.

The British Academy of Audiology will work alongside NHS Lothian Paediatric Audiology Service, to support them to ensure quality of service provision and restore confidence in the services they offer.

Supporting fellow professionals
The BAA will share professional learnings with our membership and the wider profession, to ensure the lessons learned are understood and that other services across the home nations are offering a quality-first service to patients.

As a professional body, the BAA (with appropriate partners) will develop and publish guidance to support Paediatric departments to provide outstanding services for babies, children and young people.

The BAA will also seek to ensure audiology staff who raise whistleblowing concerns about clinical care are supported appropriately.

The BAA board recognise the volume and nature of the work undertaken by the Review Panel and the Governance Review team and thank them for their time and commitment.

NHS Lothian Press Release

BAA Summary Report_NHS Lothian Paediatric Audiology

BAA Audit Report_NHS Lothian Paediatric Audiology

BAA Governance Report_NHS Lothian Paediatric Audiology