BAA has written to senior representatives from NHS England and the Department of Health and Social Care, to raise serious concerns about the current operation of NHS screening programmes without appropriate national clinical leadership and embedded expertise.
Our correspondence focuses in particular on the Newborn Hearing Screening Programme (NHSP), where recent organisational changes have removed clinical experts from the core of programme delivery. Historically, NHSP has relied on strong national clinical oversight to ensure a safe, high-quality, and accountable pathway from screening through to diagnosis. This expert leadership has been central to maintaining programme integrity and preventing avoidable harm.
Following NHS England’s recent restructure, clinical oversight has been displaced into limited external contracts, often held by individuals with substantial competing responsibilities. Many of these contracts have since been reduced, left vacant, or removed entirely in the context of financial savings. At the same time, Programme Advisory Boards, which previously provided essential challenge, scrutiny, and accountability, were stood down.
We believe these decisions represent a significant erosion of safeguards and create clear patient safety risks. This is particularly concerning given that internal expertise exists but has not been utilised, leaving programmes operating knowingly at risk.
The importance of expert clinical oversight is well established. The 2020 Rapid Review into Audiology explicitly recommended ongoing scrutiny by clinical experts, and the recent Kingdon review highlighted the damage caused by removing expert oversight from the diagnostic elements of the same pathway. The parallels with the current situation in newborn hearing screening are deeply troubling.
We also referenced lessons from 2013, when warnings about the removal of oversight in paediatric audiology services were raised but not acted upon. The consequences of that inaction have been devastating for children and families, with litigation costs now estimated at around £3 million per child, alongside irreversible lifelong impacts that financial redress can never undo. We are deeply concerned that current changes risk repeating this history within the newborn hearing screening programme.
Safeguarding the integrity of newborn hearing screening is fundamental to a child’s future. Decisions being taken now will determine whether children born with hearing loss are protected by a safe system or exposed to avoidable harm.
In our letter, we formally requested:
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A clear commitment that the new organisational structure will ensure appropriate national clinical oversight and embedded expertise across NHS screening programmes, including NHSP.
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Explicit assurance that voluntary redundancy measures will not result in the loss of critical programme expertise, including in IT systems, data and intelligence, programme development, equipment compliance, and quality assurance.
We have asked for urgent confirmation of how NHS England intends to address these concerns and will continue to advocate strongly for the clinical leadership and safeguards that are essential to patient safety.