NHSP management of babies who have not completed the screen and audiological assessment pathway during COVID19

This guidance has now been updated by PHE in consultation with the working group. There are no significant changes to the document apart from recommendations to screening services around babies who are reaching 12 weeks of age and who decline to be screened. Services should discuss the implications of discharging these babies with their audiology and screening teams and come up with a local plan if they wish

Updated guidance: NHSP management of babies who have not completed the screen and audiological assessment pathway during COVID19 v2 0506

Original document and announcement:

The British Academy of Audiology (BAA) and British Society of Audiology (BSA) are pleased to inform members that NHS England has published and circulated the NHSP management of babies who have not completed the screen and audiological assessment pathway during COVID19

Please note that whilst a BAA/BSA working party contributed to the document, ownership of final content is retained by NHS E. 

This document is designed to offer clarity both to Newborn Hearing Screening teams on what to do with the cohort of babies who have missed the screen and audiology services on diagnostic options for babies whom have not been seen for diagnostic testing. A summary of the document and our interpretation of it can be seen below.

This guidance should be used once service restrictions put in place due to Covid-19 begin to relax. It is envisaged that this will be at different times in different providers across the country and the decision on when to lift restrictions should be taken at a local, provider level.

In summary, this document allows/gives:

• Hearing screening services clarity on what to do with each type and age group of babies who have missed the screen to allow them to be screened appropriately to allow for the most effective ‘catch up’.
• Advice for Audiology departments on which babies to prioritise – it is excepted that different services may have imposed different service restrictions, this document should, however, help to streamline the catch up of these babies
• Prioritisation on which babies to offer appointments should be done on clinical need and risk of a hearing loss, not on the need to meet waiting time targets.
• As babies are born and referred, services with backlogs should continue to prioritise them based on clinical need (e.g. a service with a backlog of bilaterally referred NICU babies should see these first, before a new referral of a well-baby unilateral)
• Where there are significant capacity issues in the ABR service due to the number of babies awaiting diagnostic testing, services may choose to not see babies which have unilaterally referred the screen for immediate ABR testing and defer them for later behavioural testing with several caveats – this should not be seen as a long term solution and services should carefully consider the impact on the behavioural part of the audiology services
• ABR traces from older babies must be judged and peer-reviewed on the same criteria as in the usual BSA procedures. There is no relaxation of the 3:1 criteria for clear response or minimal noise levels for response absent

This process has brought to light several inconsistencies within the NHS E approach, which the BAA will be addressing in due course. Meetings continue and this document will continue to be reviewed.

For comments on the document or queries, people are welcome to contact the BAA on admin@baaudiology.org