A Scottish health board has apologised for “horrendous” failings after an independent review found that deaf children missed out on vital cochlear implant surgery because of mistakes and delays in diagnosis. NHS Lothian apologised to the families involved as the report set out repeated errors in identifying hearing loss and admitted the delays would have long-term consequences for the speech and language development of the children involved. An independent investigation of NHS Lothian’s paediatric audiology service uncovered “significant failures” over a nine-year period in 14% of cases after sampling more than 1,000 patient records, in particular amongs the under fives. Experts agree that early identification and correct care are vital in helping deaf children develop language and communication at this crucial age. Cochlear implants expose hearing-impaired children to the sensation of sound. The report was commissioned by the health board after criticism about the care of a child with hearing difficulties and was carried out by the British Academy of Audiology. It highlighted the average age of diagnosis of hearing loss at NHS Lothian between 2009 and 2018 was 1,653 days, or 4.5 years old, compared with 109 days in England. The report also found that 12 children who were eligible for cochlear implants faced significant delays, to the extent that five missed out on getting them altogether; 49 children had a delayed identification of hearing loss or the fitting of their hearing aid; and 30 were not offered the correct hearing aids. Responding to the report, chief executive at the National Deaf Children’s Society Susan Daniels said: “The horrendous findings in this report represent a real-life nightmare for the families involved. They placed their trust in a service that was supposed to help, only to be completely let down. Some will be left with life-changing consequences, while many others across Scotland will now be facing the very real fear that the same thing could happen to them.” Following the report, the charity called for an urgent country-wide review, warning that thousands more children treated at NHS Lothian could have been affected. “This means we need urgent action from the Scottish government, starting with a thorough review of children’s audiology services across the country. Until we have national leadership, better data collection and mandatory standards that services must comply with, thousands more deaf children could be at risk and families won’t be able to rest.” The review found no evidence that national protocols on hearing tests for children had been followed “at any point since 2009” and that delays had gone “unreported and unnoticed.” Scotland’s health secretary, Humza Yousaf, called on the health board to enact the report’s recommendations “as a matter of urgency” and apologised directly to the families involved. “I am deeply disappointed at the unacceptable failures this report has highlighted, and I have already made my views unequivocally clear to NHS Lothian,” he said. “The service provided to children affected and their families was simply not good enough.” Tracey Gillies, medical director at NHS Lothian, said: “We are very sorry and saddened to learn that there are some children whose conditions were not diagnosed correctly, or as early as possible, as a result of testing that was not up to standard. “We have already written to the most severely affected families individually to offer support and a face-to-face meeting to discuss their child’s condition. We have also arranged appointments for those children whom the review recommends should be tested again.”