14 November 2025

NCHA response to the Kingdon review of children's hearing services

As the association for primary care audiology providers, we welcome the Kingdon review into NHS hospital paediatric audiology services.

The Kingdon review highlights how at least 300 children have suffered harm in England due to avoidable system failures, with warnings not acted on for over a decade.

Children and families that have suffered because of these system failures have been part of the review, many sharing how they were not listened to and some highlighting how they had to pay for private services to secure timely care. 

The review sets out clearly how the NHS failed to act promptly despite the growing body of evidence that there were significant problems with the service.

The review focuses on the period from December 2021 to March 2025, noting that audiology is still viewed as a "Cinderella service". While the review recognises that many of the issues that have been identified are not new, the reality is that NHS hospital audiology services have suffered repeated system failures for more than four decades, and many reviews have highlighted the low priority afforded to audiology as a root cause. The Kingdon review is therefore right to focus on systems, not individuals, and to challenge any bullying and other poor workplace practices within hospitals.

The NCHA welcomes and supports the review recognising  

• the need for the NHS to invest in ensuring children receive timely access to quality care and the proposal for a 'network model' for children's services to ensure that expertise can develop in sustainable units while also offering care closer to home. This builds on the 2008 Department of Health review of children's service which also highlighted variation in quality and access and yet was not implemented nationally or sustainably
• the need for children's services to be commissioned using a modern service framework and model commissioning contract. This should build on the 2016 NHS national commissioning framework for hearing loss which included a model service specification for children that has not been implemented
• the need to ensure all audiologists have CPD standards and are accountable. HCPC registration already achieves this and includes thousands of audiologists (hearing aid dispensers and clinical scientists). There is a voluntary system for non-HCPC registrants, which means other audiologists can join a PSA accredited register. We will work with DHSC and NHS England to make the case for professional regulation for all audiologists in the best interests of patients. This will help ensure that we build on what works and avoid revisiting models that have previously failed.

We also welcome that the Kingdon review recognises the limitations of IQIPS that we have previously raised.

The review goes on to cover fragmentation across the professional bodies in audiology. While the review suggests that the number of professional bodies is a challenge, our analysis shows that many other healthcare professions with multiple sector bodies have not suffered repeated system failures. What the sector lacks is an independent College that sets professional norms without bias towards the location where professionals work. That is why in 2015 the NCHA, following concerns about protectionism in the sector potentially distorting clinical guidance, proposed the sector establish a College of Audiology that was

• Independent, evidence-based, open and transparent - free from undue influence of any nature
• Accountable to the Charity Commission against a robust charter and operating rules, demonstrating the highest levels of probity
• Focused on public benefit and improving outcomes, care and access for all.

We still strongly support the establishment of a College of Audiology that is consistent with these principles. The public interest test and accountability must be at the heart of any college if we, as a sector, are to overcome the historical and outdated models of silo working and professional guidance being created to preserve models of care as opposed to meeting population needs in a sustainable and safe way.

While the service issues highlighted in the report are not provided by NCHA members, we remain committed to working with DHSC and NHS England to ensure the 10 Year Health Plan is delivered in ENT and audiology, and in doing so addressing the root causes of the issues identified in the Kingdon review. Delivering the shift from hospital to community, focusing on prevention, and shifting from analogue to digital will help the NHS audiology service better align to population needs, release hospital capacity and support specialisation and sustainable models of care in areas including paediatric audiology.

End

Notes for editors
The NCHA is the representative body for primary care audiology. We exist to improve ear and hearing care for all and work with the NHS, health and social care bodies and policymakers to make this happen.

Primary care audiology - accessible ear and hearing care for all sets out why audiology systems in the UK have suffered from repeat system failures and how to address this based on population need, and clinical and economic evidence.

System issues in audiology can often be traced back to a lack of priority afforded to audiology services - e.g. policymakers not acting on evidence about barriers to care, failing to act on data that indicated significant capacity issues, overlooking the fact that hearing loss is a long-term condition, and not addressing waiting list problems. These issues will snowball unless action is taken at an early stage. This lack of forward planning is also at the heart of multiple but avoidable system failures. For examples, see endnote 1 here.

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