United Kingdom

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United Kingdom

  • Population (2012 est): 63,047,162
  • Number of Annual Births (2012 est): 773,600
  • Birth rate: 12.27 per 1,000
  • Percent of GDP spent on health care (2009): 8.7%
  • Percent of Health Care expenditures spent by government: 82.6%
  • Physician density: 2.739 per 1,000
  • Percent of newborns attended by skilled providers: N/A
  • Infant Mortality: 4.56 per 1,000
  • Literacy (age 15 and over can read and write): 99%
  • Percent of children screened for hearing loss:
  • Incidence of permanent hearing loss among newborns:

Current Status of Early Hearing Detection and Intervention for Children (500 word limit)

Since 2006, newborn hearing screening has been offered to the parents of all babies in England. Since then, more than 3.5 million babies have been screened and 5200 cases of permanent childhood deafness detected in one or both ears. The test is optional but 99.8% of parents take up the opportunity. Across England, there are 118 local hearing screening services with over 2000 trained health care professionals carrying out the screening.

Two models are used:

  • in hospital before discharge – if discharge takes place before the test is completed, a letter is sent asking the mother to attend an appointment for the screening test; and
  • in some areas the test is done at home by a health visitor nurse.

The Newborn Hearing Screening Programme (NHSP) is guided by a comprehensive set of national standards which state that screening must be offered and completed for all well babies in hospital-based programmes by 4 weeks of age. For well babies in community-based programmes the standard is 5 weeks.

Two methods are used – automated otoacoustic emissions (AOAE) testing and automated auditory brainstem response (AABR). AOAE testing is carried out, and where there is no clear response in one or both ears then a second screening is conducted using AOAE and/or AABR. If there is no clear response on the second screening, the baby is referred to the local paediatric audiology department for follow-up. NHSP standards state that the family should receive a referral in 3 working days and that a baby should be seen in audiology no more than 4 weeks from the second screening.

NHSP quality assurance is underpinned by a national information and performance management system. Every local hearing screening programme in England uses this system to capture data from the screening tests. System functionality and analysis make it possible to assess local performance against national quality standards; to compare performance between different sites; and to track the progress of babies referred after screening through the early assessment care pathway. Standards also exist for the provision of support to parents and services for children following the identification of hearing loss.

Moving forward, the challenge for the NHSP is to maintain quality and drive its high standards through to audiological assessment and parental support. The NHSP must also continue to reduce health inequalities, and to work with health care and education professionals to ensure that babies who are diagnosed as deaf get the best outcomes from early interventions – including hearing aid services, cochlear implants and educational support. A major challenge at present is ensuring appropriate electrophysiological assessment after screening, as compliance with protocol has been found to be problematic in up to 10% of programmes.

Improving the health and well-being of children through prevention and early intervention – within the context of an integrated approach to supporting children and families – remains the key priority. In support of this, the NHSP will continue to work alongside other newborn and antenatal screening programmes to identify improvements and share best practice.

Publications about EHDI Programs in the United Kingdom (maximum of 5)

  1. World Health Organization. 2010. Newborn and infant hearing screening- current issues and guiding principles for action. WHO Report 2010:1-39.

Person responsible for most recent update: