Today, the Department of Health and Social Care (DHSC) publishes the long-awaited Kingdon Review into Children’s Hearing Services in England. Led by Dr Camilla Kingdon, the independent review lays bare the systemic failings that have impacted hundreds of deaf children and their families across the country. The report highlights missed diagnoses, inconsistent service quality, and a lack of national oversight—issues that have led to delays in treatment during critical windows of child development.
Dr Kingdon’s findings are stark: more than 300 children have already been harmed, and the true number may be higher. The review calls for urgent action across 12 key recommendations, including modern commissioning frameworks, a unified professional register, improved governance, and a networked model of care to replace isolated service pockets.
In an interview the Sunday Times yesterday (9th Nov), Dr Kingdon called for changes in the leadership at NHS England, which she blamed for ignoring warnings, and urged Streeting to get a grip.
“Vindicated, but not complacent”
The British Academy of Audiology (BAA) has issued a detailed response to the Kingdon Review, welcoming its clarity and urgency. The BAA acknowledges the harm caused and commits to working with DHSC–NHS England, Integrated Care Boards (ICBs), regulators, and the voluntary sector to deliver rapid and lasting improvements.
BAA President Claire Benton said:
“This report echoes what audiologists have been saying for years. We now need rapid completion of the review and recall, modern commissioning with clear safety and experience KPIs, a single professional register, and clinically networked services so no clinician is left isolated, and no child is left behind.”
The BAA’s response outlines its proactive contributions over recent years, including the 2020 Rapid Review, the independent Lothian review, and the development of Paediatric Quality Standards. The Academy also calls for investment in workforce planning, CPD, and modern IT infrastructure to support safe, effective, and equitable care.
You can read the full BAA response here and access the Kingdon Review here.
The BAA response is also published in full below:
British Academy of Audiology response to the Kingdon Review of Children’s Hearing Services
The British Academy of Audiology welcomes Dr Camilla Kingdon’s independent review and thanks her for the clarity and candour with which she has distilled the issues that families and professionals have lived with for far too long. We also thank her publicly for her forthright media advocacy, which has helped keep children, and the consequences of delay, front and centre.
Most importantly, we recognise and are sorry for the impact that failures in children’s hearing services have had on babies, children and their families. We stand ready to work with the new DHSC–NHS England organisation, integrated care boards (ICBs), regulators, commissioners, professional partners, and the voluntary sector to put this right at pace and at scale.
The review’s 12 recommendations align closely with BAA’s prior warnings and published guidance (Rapid Review 2020; Lothian review 2021), and we commit to working with DHSC–NHS England, ICBs, regulators and the voluntary sector to finish the urgent recalls, modern commissioning with clear KPIs, a unified professional register, networked service models, and a rebuilt training and Continuing Professional Development (CPD) offer for paediatric audiology.
BAA President, Claire Benton, said: “This report echoes what audiologists have been saying for years. We now need rapid completion of the review and recall, modern commissioning with clear safety and experience KPIs, a single professional register, and clinically networked services so no clinician is left isolated, and no child is left behind.”
Our overarching position
- Vindicated, but not complacent. For years BAA and partners have warned that paediatric audiology lacked national oversight, consistent quality assurance, robust workforce planning and protected time for CPD; we set this out with partners in the 2020 Rapid Review, our independent Lothian review in 2021, and repeated public statements since. Dr Kingdon’s findings concur with our previous reports and statements.
- We are constructive and pragmatic. The Paediatric Hearing Services Improvement Programme (PHSIP) has been slow, and communications have too often missed the urgency families need. But we still need the programme to deliver recalls safely and consistently, and we will continue to help it do so.
- We welcome a unified professional register and voice. We back the principle of a single register for all audiologists and will continue to support DHSC to design something that is clear for employers and credible for the public, while ensuring audiologists’ specialist paediatric skills are recognised. With Clinical Scientists (Audiology) and Hearing Aid Dispensers registration being mandatory with the HCPC, this is an avenue BAA would look to support. There must be robust fitness-to-practice processes and resourcing for mandatory CPD.
- Networked models, not isolated pockets. We strongly support Dr Kingdon’s “network” model of locally accessible care, clinically connected teams, and routine peer supervision, rather than services working in isolation or purely hub‑and‑spoke arrangements. Whilst BAA support services delivering locally, we need to recognise that specialist services such as paediatrics, often need to remain in specialist provision.
- Paediatric audiology is far more than ABR traces. We must ensure that DHSC appreciates that Paediatric audiology extends far beyond ABR interpretation, which has been the main focus for NHS England so far. Whilst ABR is really important, it has received a disproportionate focus in the programme and review thus far. BAA would like to see the work on supporting improvement in all aspects of ABR continue, but also with an increased scope to include behavioural hearing testing as well as physiological measures (OAEs, tympanometry), hearing-aid fitting and verification, complex pathway coordination, family counselling, deaf awareness and language access: skills that are reflected in BAA’s Paediatric Quality Standards and BSA guidance.
What BAA has already provided whilst the review has been running
Quality standards & audit: BAA Paediatric Quality Standards (with an audit tool) to benchmark services and drive improvement. Other supporting resources to assist departments with their quality and audit processes.
Education: BAA’s 2023 Curriculum Guidance for Higher Education providers sets minimum threshold competencies for audiology programmes, including paediatric content. Released the BAA Scope of Practice for Audiology.
Campaigning & advice: 2020 Rapid Review recommendations (oversight, commissioning, IQIPS; peer review) pre‑figured many of Dr Kingdon’s proposals. BAA has repeatedly pressed for action through statements, news updates and meetings with NHS England representatives across several departments.
Member support & peer networks: National conference programmes, a rolling CPD webinar series and a UK‑wide Regional Groups network that shares practice, offers supervision and routes concerns to the Board. The 2023 BAA Bamford lecture, provided by now president, Claire Benton, shares striking thematic parallels with the Kingdon Review, with both exposing systemic weaknesses in paediatric audiology and advocating for urgent reform.
Public advocacy: Regular news responses on paediatric service issues, including commentary on the Paediatric Hearing Services Improvement Programme (PHSIP) communications and timelines. BAA provided important wellbeing workshops to the initial sites identified in the PHSIP. These workshops were a series of opportunities for audiologists to come together for professional and peer support.
More details about all the areas that BAA volunteers have contributed towards whilst supporting the review, and paediatric audiologists, are listed under the recommendations below.
BAA response to Kingdon Review recommendations
Recommendation 1: Refocus national programme on completing review & recall
BAA fully support this recommendation. DHSC needs to ensure urgent, region‑enabled incident responses with a centrally supported methodology. There needs to be a properly resourced national support team, that must now work at pace to complete the required work.
What we’ve done:
- Contributed subject‑matter expertise to early national actions, contributed to all working groups as part of the PHSIP and hosted webinars to brief services on the operational guidance.
- Supported members involved in service recovery through professional forums, updates, and advocacy.
- Communications and member resources to help audiologists navigate recall processes and share best practices.
Our ask of DHSC/NHSE:
- Fund the core programme team properly and empower regions to use incident structures, as the review advises. BAA calls for flexibility on DM01 to prioritise reassessment.
Recommendation 2: Modern commissioning framework, model contract, KPIs, and ring-fenced QA/CPD; support IQIPS
BAA strongly agrees with this recommendation. We have consistently promoted IQIPS and quality management and have provided practical resources to help services start the journey. BAA contributes to service improvement by publishing standards, promoting IQIPS accreditation, and engaging with NHS England. Our guidance helps shape expectations around quality, safety, and patient experience.
What we’ve done:
- BAA Paediatric Quality Standards (with audit tool) launched which map to IQIPS and provide a stepping‑stone to accreditation.
- BAA Quality Improvement Toolkit resource created for all members as an additional step to IQIPs.
- Starting from Zero Quality Improvement tool, with Audit tool made available to all audiologists.
- Paediatric Minimum Discharged Criteria guidance published with audiology partners. Webinars to support the guidance were provided and remain available.
- We regularly platform UKAS and IQIPS readiness in BAA channels (briefings, conference sessions).
Our ask of DHSC/NHSE/ICBs:
- Adopt a national model contract with safety/effectiveness/patient‑experience KPIs and ring‑fenced time for audit and CPD in job plans, as the review proposes.
- Provide capital to modernise rooms and equipment. Audiology is a tech-driven profession, already using AI-enabled hearing solutions and remote-fitting tools. But many services can’t take advantage of this innovation because they’re working with outdated equipment and unclear IT support. We need serious investment in modern audiology IT systems so professionals, and patients, can fully benefit from the AI capabilities already here.
Recommendation 3: Professional registration and unified representation
BAA supports this recommendation and would advocate for all audiologists/hearing aid dispensers/clinical scientists(audiology) to be registered with one body with mandatory CPD, audit of individual professional portfolios and robust fitness-to-practice processes. We promote registration, support HCPC standards, and collaborates with other organisations to strengthen professional governance. Our advocacy aligns with the call for a unified register and clearer engagement with national institutions.
What we’ve done:
- Published the updated BAA Scope of Practice document for 2025. Following this publication, we now have a working group looking at developing standardised job descriptions and job plans for all Agenda for Change bands, highlighting the importance of protected time for CPD.
- Provided curriculum guidance to HEIs to align pre‑registration competencies and reduce ambiguity for employers and graduates.
- Designed and facilitated the Higher Training Scheme, one of the only training programmes available to upskill audiologists in competencies such as paediatric assessment and habilitation. During the review, an equivalency process was designed to fast-track competency proof. 40+ paediatric audiologists completed this.
- Restarted ‘collaboration/college’ talks with other audiology bodies in the UK, with a view to work together to eventually form a college of audiology.
Recommendation 4: Network model for service delivery
BAA agrees with this recommendation. Networks reduce isolation, enable supervision and keep complex care close to home. This complements (not competes with) Community Diagnostic Centre capacity when CDCs are explicitly embedded in an audiology network with clear clinical accountability.
What we’ve done:
- Sustained peer networks through BAA Regional Groups and national events; promoted ABR peer‑review culture consistent with national guidance.
Recommendation 5: Improved governance (lead healthcare scientist in trusts; expertise in ICBs/regions)
BAA supports this recommendation. Audiology needs visible scientific leadership with direct board reporting. We welcome the introduction of the National Specialist Advisor (NSA), although communication from the CSO’s office has not been transparent so far. BAA welcomes the NSA position, but this leadership needs to be replicated throughout the system i.e., in region, ICB, and at Trust level, for any of the recommendations to be effective and sustainable.
BAA encourages members to engage with governance processes and supports leadership development. Our resources help audiologists advocate for better oversight and representation within NHS structures.
Recommendation 6: Improved data & KPIs, published annually; national benchmarking of treatment options
BAA strongly agree with this recommendation. The absence of consistent, transparent data has hampered improvement. The current DM01 approach is too simplistic, and potentially detrimental to quality, so this really needs a holistic review. BAA recognise the importance of timely access, but quality is hugely important.
BAA promotes audit, benchmarking, and quality improvement through its CPD offerings and member guidance. It supports the use of data to monitor service performance and outcomes.
Recommendation 7: Redesign undergraduate/postgraduate pathways and CPD; independent assessment of diagnostic ability; explore Advanced Practice
This is a core focus for BAA. We offer CPD resources, support training pathways, and collaborate with educational bodies to improve curricula. Our work directly supports the redesign of paediatric audiology training and ongoing professional development. BAA would welcome a mandate from DHSC-NHSE for this provision.
What we’ve done:
- Provided curriculum guidance to HEIs to align pre‑registration competencies and reduce ambiguity for employers and graduates.
- Designed and facilitated the Higher Training Scheme, one of the only training programmes available to upskill audiologists in competencies such as paediatric assessment and habilitation. During the review, an equivalency process was designed to fast-track competency proof. This was completed by 40+ paediatric audiologists.
- Published the updated BAA Scope of Practice document for 2025. Following this publication, we now have a working group looking at developing standardised job descriptions and job plans for all Agenda for Change bands, highlighting the importance of protected time for CPD.
- Provided a professional development webinar programme throughout 2025
- Consistently provided the biggest audiology conference for UK audiologists with three education streams and approximately 45 specialist presentations from national and international experts.
- Launched a new E-learning programme looking at specific audiology and leadership competencies.
Recommendation 8: Invest in research and innovation
BAA supports this recommendation. We promote audiology research through our annual conference with free paper and poster presentations, our magazine and other publications, and member engagement. We encourage innovation and evidence-based practice, though funding decisions lie with national bodies.
BAA appreciates the work of a dedicated group of researchers who have recently published the James Lind Alliance (JLA) Priority Setting Partnership (PSP) in Childhood Deafness and Hearing Loss. The JLA PSP worked with a wide range of adults and children with experience or professional understanding of childhood deafness to identify the Top 10 research priorities.
Our ask: Ring‑fenced CPD budgets for healthcare scientists at parity with AHPs and medics; funded clinical educators; expansion of HEI places; and formal recognition of supervised paediatric practice in early careers.
Recommendation 9: Deaf awareness and accessible feedback
BAA strongly support this recommendation. Children’s hearing services should model best practice in deaf awareness and communication access. BAA champions deaf awareness and patient-centred care. We have provided training webinars and guidance on communication needs and promote inclusive feedback mechanisms to improve service quality.
What we’ve done:
- Co‑promoted accessible information standards (articles and webinars) and deaf‑awareness practice, curated member resources and webinars.
What we will do next:
- Co-host a stand at the November 2025 BAA conference called ‘Accessible Audiology’ showcasing ways that services can provide a service that is accessible to all.
- Create e-learning modules on deaf awareness for professionals working in audiology.
Recommendation 10: Workforce planning for healthcare science and culture/morale
BAA agree with this recommendation. Morale, retention and pipeline are existential issues. NDCS Listen Up reports and the Kingdon Review both highlight vacancies and training gaps.
What we’ve done:
- Met several times over the last three years with the Chief Medical Officer of England and other representatives of NHS England to highlight the workforce crisis and lack of planning.
- Pushed for initiatives to increase numbers of students, funding for courses, international recruitment initiatives etc.
- Fed into workforce modelling exercises with NHS England, providing indicative mean timings for activities and minimum bands for example.
- Currently working with the NHS England workforce group and their advisor to support the recruitment process for leadership roles.
- Supporting the development of an International Recruitment drive, including the appointment of an advisor and skill mapping.
Recommendation 11: Regional incident response model and horizon scanning
BAA supports this recommendation. This would have materially improved pace and consistency since 2023.
What we will do next:
- Offer audiology expertise to any ‘special projects’ and horizon-scanning functions.
Recommendation 12: Guidance on escalation to ministers
BAA agrees with this. Families deserved earlier transparency; codify triggers and responsibilities. BAA would like to see the same improved clarity of communication extended to all stakeholders including professional bodies, the workforce, and the public/service users.
Guardrails on service redesign
We caution against dispersing paediatric audiology into isolated community pockets without formal network governance. Community Diagnostic Centres can add capacity only when embedded within an audiology network with shared protocols, scientific oversight and supervision, with the same expectations for governance and quality assurance expected for hospital-based services.
We acknowledge the commitment of individual PHSIP staff and regional teams, often working in under‑resourced conditions. Many of the BAA Board Directors have volunteered hundreds of hours to this programme. Nevertheless, the programme’s pace and communications did not consistently reflect the time‑critical nature of language development in early childhood.
We welcome the Review’s call to reset, resource it properly, and let regions use incident structures to finish review/recall promptly. BAA will continue to be an honest partner, supportive, but will continue to insist on urgency and transparency.
Appendix A — Evidence that underpins our response
Kingdon Review (Final report, 2025): https://www.gov.uk/government/publications/kingdon-review-of-childrens-hearing-services-final-report
Kingdon Terms of Reference (Apr 14, 2025): https://www.gov.uk/government/publications/kingdon-review-of-childrens-hearing-services-terms-of-reference/kingdon-review-terms-of-reference
PHSIP operational guidance (Sep 24, 2024): https://www.england.nhs.uk/long-read/paediatric-hearing-services-improvement-programme-operational-guidance/
PHSIP letter & guidance (Sep 24, 2024): https://www.england.nhs.uk/publication/paediatric-hearing-services-improvement-programme-letter-and-guidance/
National position & mutual aid (Jun 4, 2025): https://www.england.nhs.uk/long-read/national-paediatric-hearing-services-improvement-programme-national-position-waiting-times-mutual-aid-and-next-steps/
BAA Scope of Practice (Aug, 2025): https://baaudiology.org/wp-content/uploads/2025/08/OD1755-BAA-Scope-of-Practice-August-2025.pdf
BAA Paediatric Minimum Discharge Guidance (Aug 22, 2024): https://baaudiology.org/wp-content/uploads/2024/08/Minimum-Discharge-Guidance-August-2024.pdf
BAA Rapid Review (Oct 14, 2020): https://baaudiology.org/rapid-review/
BAA NHS Lothian review (Dec 10, 2021): https://baaudiology.org/nhs-lothian-full-baa-statement-and-reports/
BAA Statement on DHSC Review (Apr 30, 2025): https://baaudiology.org/baa-statement-in-response-to-dhsc-paediatric-audiology-review-announcement/
BAA Paediatric Quality Standards (Jul 2022): https://www.baaudiology.org/wp-content/uploads/2023/04/BAA-Paed-QS-final-version.pdf
BAA Paediatric Support page: https://baaudiology.org/professional-information/baa-paediatric-support/
BAA Curriculum Guidance (May 2023): https://baaudiology.org/wp-content/uploads/2023/05/BAA-Curriculum-Guidance-Document-Audiologist-May-2023.pdf
BAA News archive: contemporaneous responses to media reports and programme updates. [baaudiology.org]
BSA ABR Peer Review Guidance (2019): https://www.thebsa.org.uk/wp-content/uploads/2023/10/FINAL-Practice-Guidance-Principles-of-external-peer-review-of-auditory-brainstem-response-ABR-testing-in-babies-Nov2019.pdf
BSA Early assessment & management (2021): https://www.thebsa.org.uk/wp-content/uploads/2022/10/OD104-98-BSA-Practice-Guidance-Early-Assessment-Management.pdf
James Lind Alliance (JLA) Priority Setting Partnership (PSP) in Childhood Deafness and Hearing Loss (Sep 18, 2025): https://childdeafnessresearch.co.uk/
NDCS Listen Up 2024 (England): https://cms.ndcs.org.uk/sites/default/files/2025-05/Listen%20Up%202024%20-%20England.pdf
UKAS IQIPS progression pathway (Jul 24, 2025): https://www.ukas.com/resources/latest-news/new-progression-pathway-launched-to-support-paediatric-audiology-services-on-their-journey-to-iqips-accreditation/