11 October 2024

Audiology failings behind poor diagnostics performance

The Hertfordshire and West Essex (HWE) integrated care system (ICS) has blamed audiology delays at one of its trusts for poor performance in diagnostic testing.

According to an analysis by the Health Service Journal, HWE is one of just three ICSs responsible for nearly a quarter of 13-week waits for diagnostic tests.

The HSJ reported that the East and North Hertfordshire Trust had to pause audiology services after an NHS England national review into children's audiology services said it required improvements.

Looking at 13-plus week breaches from May to July, South East London, Bedfordshire, Luton and Milton Keynes, and HWE accounted for 28,869 (23%) of the national total of 127,107, with HWE at 7 per cent of the total.

HWE said it would tackle the problem by hiring more audiologists and referring patients to other services, prioritising those with the most serious clinical need.

The trust is one of many that are the focus of NHS England's paediatric audiology improvement programme, which responded to revelations of widespread missed diagnoses following a referral from the newborn hearing screening programme.

NHS England has revealed that 90 out of 140 audiology departments in England require "more detailed focus and support from clinical experts to find out which babies and children need to be recalled for reassessment".

Sir Stephen Powis, NHS England's national medical director, and Dame Sue Hill, the NHS chief scientific officer, said in a blog that they were committed to "finding the best way to review, recall and reassess affected babies and children, so we can give them the diagnosis and treatment they need".

They cited a need to address the staff shortage with the correct skills, improve quality standards and ensure that audiology departments are big enough to give employees the experience they need to maintain their specialist skills.

The Times has reported that leaked internal documents from NHS England reveal a nationwide failure in children's services, citing figures showing that clinicians have misdiagnosed 1,540 children since 2019. Of them, 480 were reported to have suffered moderate or severe harm, which included permanent speech and language delays.

Meanwhile, NHS England figures for August 2024 revealed that audiology had the highest increase in the proportion of people waiting six weeks or more for a hearing test compared with other diagnostic tests, rising by 10.4 percentage points on the previous year to 48.3%.

Audiology had the second highest increase (in six-week waits) after electrophysiology in the list of 15 different types of tests, including MRI and CT scans, urology and echocardiography. This outcome is despite audiology representing the largest increase in assessments year-on-year, with an average monthly increase in activity of 1.1%, suggesting that total capacity is struggling to keep up with demand.