Review finds ‘multiple, systemic problems’ in NHS audiology services

A review has highlighted “multiple, systemic problems” within audiology services in NHS Scotland, with ministers being told change is needed to “develop the services patients deserve”.

Commissioned by First Minister Humza Yousaf when he was health secretary, the study comes in the wake of failures in audiology services at NHS Lothian which impacted 155 patients and led to some children being identified as deaf years later than they should have been.

Public health minister Jenni Minto, speaking after the report was published, said: “We must recognise that many families were badly let down by these services in the past and this report’s recommendations will help ensure that is not allowed to happen again.”

The independent review, led by Professor Jacqueline Taylor, looked at three key areas for services – structure, governance and leadership, the education and training of audiology staff, and quality assurance – and identified a “range of concerns in all the areas scrutinised”.

It said there had been an “absence of national leadership, strategic planning and workforce planning” in audiology services, and added that in recent years there was “no quality assurance of services” despite national standards being in place for both adult and paediatric audiology services.

It went on to say there is “clear evidence of workforce shortages, limited access to undergraduate and postgraduate training programmes and few opportunities for continuing professional development (CPD) and skills maintenance and acquisition once in post”.

It concluded: “There are multiple, systemic problems within audiology services in NHS Scotland. Resolving these requires a whole-system approach.”

With an estimated 70% of over-70s having some degree of hearing loss, and with one or two babies in every 1,000 born with hearing loss in one or both ears, the report said there is now a “once-in-a-generation opportunity to aim not just for safe, acceptable services, but for excellence, and to develop the services patients deserve”.

A total of 55 recommendations for change are made, with the report saying these would “ensure high-quality, joined-up, patient-centred services”.

But it added: “It is stating the obvious to say that the recommendations can only have this effect if they are implemented.”

A “fundamental requirement” therefore is for an implementation group to be established, with this to include patients and to report directly to the Scottish Government.

Other recommendations include a “comprehensive” workforce review, and the development of a “robust workforce plan to ensure appropriate safe-staffing levels and equitable patient-staff ratios”.

The report said: “This is not the time for a half-hearted response or for a sticking-plaster approach.

“This is a time to acknowledge the systemic issues and to use this report as the catalyst for a transformation process, which will require vision, national leadership and accountability.

“It will require planned investment in the education and training of our audiology professionals to ensure the right numbers are available with the required skills.”

Prof Taylor said she hopes the Government will “respond positively to the recommendations and will ensure that the words in this report are turned into actions”.

She added: “The wide-ranging recommendations in this report provide the foundation for improvements which will ensure high-quality, joined-up, patient-centred services.

“We have listened carefully, and I believe that by working together, we have a real opportunity to develop excellent services across Scotland.”

Ms Minto said: “The report is clear in its call for better leadership, structure and governance at all levels.

“Some of the recommendations are in areas where we are already taking action, such as increased funding for staff training.

“What is abundantly clear in their findings is that good audiology care can be life-changing, and patients recognise and value the expertise and compassion of staff.”

She pledged ministers will “fully consider the findings” and then set out their response to Parliament “in the coming months”.