Newborn hearing screening standards: consultation

The NHSP programme aims to support health professionals and commissioners in providing high quality NHSP screening services. This involves the development and regular review of quality standards against which data is collected and reported annually. The standards provide a defined set of measures that providers should meet to ensure local programmes are safe and effective. They also help to drive improvement. The NHSP standards were last revised in 2018 following a comprehensive review.

A task and finish group was established in 2020 to carry out a major review of the 2018 NHSP standards covering the screening journey up to and including the point of referral to audiology and entry into audiological assessment. The group reviewed the 2018 standards and identified necessary changes and areas to target for improvement. Performance data for each screening year from 1 March 2017 to 30 April 2020 was reviewed. A screening inequalities assessment was completed to consider the impact on the eligible population. The group drafted proposed revisions which were presented to the Screening Data Group before going out to wider consultation.

NHSP consulted on 7 standards using a survey. The standards document and a link to the survey were published on the PHE Screening blog. The consultation was open for 4 weeks and closed on 24 June 2021. Participants could answer questions on all of the standards or select standards of interest.

The standards

The existing NHSP standards are:

• NHSP-S01: coverage

• NHSP-S02a: test – well babies who do not show a clear response in both ears at automated otoacoustic emission 1 (AOAE1) – hospital model services

• NHSP-S02b: test – well babies who do not show a clear response in both ears at AOAE1 – community model services

• NHSP-S03a: test – referral rate to audiological assessment – hospital model services

• NHSP-S03b: test – referral rate to audiological assessment – community model services

• NHSP-S04: referral – time from screening outcome to first offered appointment for audiological assessment

• NHSP-S05: diagnosis/intervention – time from screening outcome to attendance at an audiological assessment appointment

Proposed changes

The proposed changes were:

• the title, description, rationale, definition, caveats, data collection and reporting and the reporting periods would be updated to incorporate specific changes and bring the wording in line with PHE recommended guidelines and other screening programme standards

• the use of corrected age would be applied to all babies whose gestational age is ≤ 40 weeks at birth

All proposed changes were published on the PHE Screening blog.

Summary of the proposed revisions to the NHSP programme standard thresholds for consultation NHSP-S01: coverage Hospital April 2018 Remain the same Proposed change to Timescale 4 weeks corrected age Yes - Acceptable ≥98.0% Yes - Achievable ≥99.5% Yes - Community April 2018 Remain the same Proposed change to Timescale 5 weeks corrected age Yes - Acceptable ≥98.0% Yes - Achievable ≥99.5% Yes - NHSP-S02a: test – well babies who do not show a clear response in both ears at AOAE1 – hospital model services April 2018 Remain the same Proposed change to Acceptable ≤27.0% Yes - Achievable ≤22.0% No ≤20.0% NHSP-S02b: test – well babies who do not show a clear response in both ears at AOAE1 – community model services April 2018 Remain the same Proposed change to Acceptable ≤15.0% No ≤14.0% Achievable ≤13.5% No ≤12.0% NHSP-S03a: test – referral rate to audiological assessment – hospital model services April 2018 Remain the same Proposed change to Acceptable ≤3.0% No >2.0% to ≤2.8% Achievable ≤2.0% No ≥0.5% to ≤2.0% NHSP-S03b: test – referral rate to audiological assessment – community model services April 2018 Remain the same Proposed change to Acceptable ≤1.6% No >1.3% to ≤1.6% Achievable ≤1.3% No ≥0.5% to ≤1.3% NHSP-S04: referral: time from screening outcome to first offered appointment for audiological assessment April 2018 Remain the same Proposed change to Timescale 4 weeks corrected age No from 4 to 3 weeks corrected age Acceptable ≥97.0% No ≥90.0% Achievable ≥99.0% No ≥97.0% NHSP-S05: diagnosis/intervention: time from screening outcome to attendance at an audiological assessment appointment April 2018 Remain the same Proposed change to Timescale 4 weeks corrected age Yes - Acceptable ≥90.0% Yes - Achievable ≥95.0% Yes -