The newborn hearing screening programme in England.

Following a systematic review of the role of neonatal hearing screening in the identification of hearing impaired and deaf children in 1997, the Department of Health in England commissioned a national programme of newborn hearing screening in 2001 and has linked a systematic evaluation to the first 23 sites in the implementation of that policy. It is anticipated that all areas of England will participate in the programme by 2004/2005. It is expected that other regions of the UK will also aim for implementation by this date. In addition to successful advocacy by the two major consumer organisations, there were three key elements linked to the decision to implement newborn hearing screening which were primarily evidence based and also driven by two significant service developments. The evidence base showed that newborn hearing screen was considerably more effective and efficient than the infant distraction test used in many areas and that there was a high probability that early intervention increased the potential for better language and communication. The concern over raised anxiety for those parents whose babies need differential assessment as a result of the screen is reduced by the low number of referrals and increased efficiency of assessment when national protocols are used for screening and assessment. The introduction of family friendly hearing services (FFHS) provides a context in which the health, education, voluntary and social services can work together to provide an equitable and seamless service throughout the year for hearing impaired and deaf children and their families. Currently, 22 areas with 110,000 births per annum, have been selected for implementation, some of whom use a pilot community-based model for screening. A major barrier to rapid progress has been a lack of evidence concerning elements of the screening process, e.g. equipment, IT systems, training at all levels. It is anticipated that a further 20-40 areas with an additional 150,000 birth per annum will be brought into the programme by end of 2002/2003. The aims, protocols, training programme and evaluation of the NHS Newborn Hearing Screening Programme are presented with a view to highlighting the research needed to improve specification of large scale screening programmes.