Guidance

1. Introduction and contacts

Updated 10 October 2024

Applies to England

About this guidance

This NHS Newborn Hearing Screening Programme (NHSP) operational guidance supports the management of local NHSP programmes in England and brings together in one place all the guidelines and recommendations that relate to the screening pathway.

To ensure the delivery of a high-quality, reliable, supportive and effective service, local screening programmes must:

  • co-ordinate and managing their programme
  • provide accessible information, support and advice for parents
  • enable parents to make a fully informed choice about hearing screening for their baby
  • treat all individuals with courtesy, respect and an understanding of their needs
  • accurately identify babies eligible for screening
  • minimise parental anxiety possibly caused by screening babies at such a young age and subsequent unnecessary investigations
  • undertake newborn hearing screening
  • record screening outcomes
  • refer appropriately for audiological diagnostic assessment
  • monitor the outcomes of audiological diagnostic assessments
  • identify babies that require targeted follow-up
  • run failsafe systems
  • report on performance against programme standards
  • promote audit and research and learn from the results
  • participate in quality assurance reviews and produce continued service improvement plans

This guidance has been based on the NHSP service specification which outlines the service and quality indicators expected by Public Health England (PHE) and NHS England (NHSE) for the population for whom it is responsible and which meets the recommendations of the UK National Screening Committee (UK NSC).

Other useful resources

To prevent duplication, a number of resources are not included in this guidance but are available elsewhere. These include national guidance on:

Contacting the national programme

Population screening helpdesk

UKHSA Screening
Floor 5
Wellington House
133-155 Waterloo Road
London
SE1 8UG

Email PHE.screeninghelpdesk@nhs.net

Helpdesk phone number 020 3682 0890

The helpdesk is not for media enquiries and does not have access to screening results. For queries about results, contact your GP or local screening service. Order screening leaflets at www.gov.uk/phe/screening-leaflets.

Contacting the press office

UKHSA press office: screening

Email screeningpressoffice@phe.gov.uk

Phone 020 7654 8120

Out of hours 020 8200 4400

Evidence base for NHSP

Infants have had their hearing screened in the UK since the early 1960s, using the Health Visitor Distraction Test (HVDT). By the early 1970s, professionals were questioning the effectiveness of this screen in terms of managing to reach and screen all infants and its ability to identify the majority of infants with permanent childhood hearing impairment early.

Professors Davis and Bamford and colleagues reported in a 1997 Health Technology Assessment review that the HVDT fails too many children unnecessarily and identifies only a relatively low percentage of infants with hearing impairment and is costly to run. Another problem is that it depends on the child being old enough and physically strong enough to turn towards the produced sound.

By the 1980s, more robust screening techniques had been developed (automated auditory brainstem response (AABR) and otoacoustic emissions (OAE)) which are capable of screening the hearing of newborn babies. It was reported in the Health Technology Review that newborn hearing screening methods are able to achieve reasonably high accuracy in terms of identifying a real hearing impairment and cost considerably less per child identified than the existing HVDT. The UK National Screening Committee therefore recommended the introduction of newborn hearing screening.