Trusts admit ‘severe’ harm to children

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More trusts report patient harm after failings in paediatric audiology
Six trusts working with NHSE to improve outcomes
Charity criticises leaving ICBs in charge of assuring quality locally

Children have suffered severe harm at two further hospital trusts as a result of failures in paediatric audiology, HSJ can reveal.

HSJ reported in July that three children at Croydon Health Service Trust may have come to “severe harm” – meaning they may have suffered permanent damage – following failures in the trust’s processes in audiology.

Now East and North Hertfordshire Trust and North West Anglia Foundation Trust have also confirmed a small number of cases of severe or serious harm; while some trusts have yet to confirm findings from case reviews they have carried out (see details below).

Major problems emerged earlier this year, initially in Scotland, of poor quality checks missing children with hearing problems who should have received support, and of a failure to inspect the services.

NHS England ordered a review of data from the national newborn screening programme which, alongside other review work, identified six English trusts as having likely failures in their service: Croydon, East and North Herts, North West Anglia, Warrington and Halton Hospitals, North Lincolnshire and Goole, and Worcestershire Acute Hospitals.

They have all been carrying out patient harm reviews, and are being overseen by a nationally managed working group. HSJ asked NHSE how many children had come to harm nationally because of the issues in paediatric audiology, but was told it did not have that information.

Trusts’ findings so far

One of the trusts, East and North Hertfordshire Trust, confirmed to HSJ that one child had come to “severe harm” and another had “moderate harm”, and 15 were defined as “low harm”. This group came from an initial cohort of 200 children who had their care reviewed, and who are also now being reviewed externally, the trust said.

A second cohort of 600 children is in the process of having their care reviewed, of which around 200 have been completed. Six of these have been referred back for a further external harm review.

In a statement, the trust said: “Our internal paediatric audiology service is currently paused and we are working with external providers to secure mutual aid for the most urgent patients, including arranging appointments at other trusts and with external accredited clinicians where feasible.”

North West Anglia Foundation Trust, which runs Hinchingbrooke and Peterborough hospitals, reported two “unexpected/potentially avoidable injury causing serious harm” incidents in its board papers.

These said staff had now received extra training and the trust was looking at making peer review arrangements across Cambridgeshire and Peterborough.

In a statement, it said there was one “confirmed” severe case.

Warrington and Halton Hospitals FT said in a statement that 200 of its test results between 2018 and 2023 had been examined by the national peer review team, and one case of “low harm” was found. The trust said of these cases were still being investigated and it was working with other UKAS-accredited organisations.

North Lincolnshire and Goole Hospitals FT said there was “some harm in a number of cases” but did not confirm how many children had been harmed when approached by HSJ.

NLAG board minutes said “a number of serious incidents had arisen” and it was considering moving to a joint audiology service with Hull University Teaching Hospitals Trust. Minutes of its quality and safety committee meeting in June said there “were now up to 17 cases of children affected”, but with no indication of seriousness.

Worcestershire Acute Hospitals Trust did not respond when approached for comment.

Croydon confirmed findings of severe harm in July.

Meanwhile, at the end of last month, the NHSE chief operating officer Sir David Sloman and chief scientific officer Dame Sue Hill wrote to the 42 integrated care boards asking them to assure themselves their providers were running a safe service.

The letter said: “We know that there are approximately 130 paediatric hearing services across the 42 ICBs and currently only 25 of these services are UK Accreditation Service accredited…

“Service issues include lack of clinical governance and oversight, poor reporting of data, poor interpretation of results, poor retention of diagnostic data.”

One charity raised concerns this role had been given to ICBs. National Deaf Children’s Society senior audiology policy adviser Samantha Lear told HSJ: “We don’t know if ICBs have the expertise in place yet, and whether they will understand what is required to really assure the quality of audiology services.

“At the moment we can’t be sure it won’t be a tick-box exercise.”

In 2020 a review by the NDCS, the British Academy of Audiology and others said the pandemic had “highlighted a lack of oversight at a national level of service provision within paediatric audiology”.