The National Audiology review – what’s next?

Hannah Tweed asks, “what next?” and calls for action from Scottish Government on the findings of the National Audiology Review.

The Scottish Government published the Independent Review of Audiology Services in Scotland on 25 August 2023. The problems highlighted in the review – and in the 2018 review of children’s services in East Lothian that prompted it in the first place – are serious, widespread, and continue to affect children and young people and their families on a daily basis. Nearly three months later, there is no clarity amongst the third sector or front-line audiology services as to how Scotland is to respond to the findings of the Review.

The Review was independently chaired by Prof. Jacqueline Taylor MBE, and focused on the following critical areas: structure, governance, and leadership of services; education and training of audiology staff; quality assurance of services. The review group also insisted that people with lived experience were involved in the process, as well as other key stakeholders. This lived experience engagement work was supported by the ALLIANCE and a reference group of relevant organisations.

The key findings of the Review include:

• No quality assurance of services, despite the existence of national quality standards for paediatric and adult audiology services.
• Clear evidence of workforce shortages. Staff had limited access to undergraduate and postgraduate training programmes, and few opportunities for continuing professional development and skills maintenance and acquisition once in post.
• Multiple systemic problems within audiology services in NHS Scotland that require a whole-system approach to be resolved to achieve high quality, joined-up, patient-centred services.
• Systematic problems with data collection, management, and analysis.

Immediate recommendations from the Review include the establishment of an Implementation Board with expertise from both professionals and people who are Deaf, Deafblind, and Hard of Hearing, and their families. This Board should report to the Scottish Government and have the necessary delegated authority and project management support to be effective.

The review group states it believes the recommendations detailed in the Report will not only improve the quality of audiology services in the short term, but also provide a sustainable structure. Governance and leadership are required to bring meaningful improvement to services.

While it takes time to develop a considered and tailored approach to systematic problems, in the wake of the Review, transparency and clear communication are needed to prevent further loss of trust. It is essential that those most affected by the current problems within audiology – people who access, or need to access services, their families and carers, and professionals – are kept informed, and involved in co-designing solutions from the outset (as outlined in the proposals for an Implementation Board). They must not be left in limbo.

Recent discussions within the British Academy of Audiology conference highlighted widespread agreement that while the Review (and equivalent investigative work in England) focused on children and young people’s audiology, it is likely that many of the same problems about access to services and support extend into adult practice. We need to see urgent action from Scottish Government to support all people who require access to audiology services, to involve them in decision making, and to value their input and the role of audiologists within Scotland.

The BSL National Plan 2023-2029, published earlier this month, states that it “represents our ongoing commitment to making Scotland the best place in the world for BSL users to live, work, visit and learn.” It also highlighted that similar steps are required to address the communication and language development barriers faced by people affected by Deafness. To deliver on such commitments, and to expand it to equally accommodate people who are Deaf, Deafblind, and Hard of Hearing, the Scottish Government needs to respond to the National Audiology Review, demonstrate transparency in its plans and communications, and act on its findings and recommendations without further delay.

More information on the National Audiology Review, and the full report can be found here.

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