North Staffordshire Clinical Commission Group (CCG) are considering scrapping providing hearing aids to people with a mild or moderate age-related hearing loss and have asked for local people’s views on the proposals.
People have been asked to fill in an online survey or attend public meetings to air their views on the proposals which would save the NHS £1.2 million per year.
According to the CCG’s website, services to children would remain unaffected and those with hearing aids already would not have them taken away.
The move to consult with patients comes after a local body, known as a Clinical Commissioning Advisory Group (CCAG), weighed up the costs and benefits of providing hearing aids for people with mild or moderate age-related hearing loss. Using a scoring system known as the Portsmouth Scorecard, they decided that providing certain hearing aids was not an effective use of NHS resources and now threaten a service, available across the UK since 1948, with decommissioning.
According to Public Health England’s website, the Portsmouth Scorecard is a method that is adopted by many heath authorities across England to guide the prioritisation of their services. Members of North Staffordshire’s Clinical Priorities Group took into account factors such as cost, benefit to patients, strength of evidence and prevention of future illnesses to end up with a score. If the score is below a set threshold, then the service may be recommended for decommissioning. Neither the score or threshold were available on the CCG’s website.
North Staffs decision could have implications nationwide – while they appear to be the first in the UK to consider scrapping the provision of hearing aids for mild or moderate hearing loss, others authorities using the same system could reach the same outcome as part of a drive to cut costs.
2500 people have been identified as having a mild or moderate hearing loss in the North Staffordshire area but millions of people may be affected if the proposals are copied nationwide. Research undertaken by Action on Hearing Loss found that 10 million people in the UK have some kind of hearing loss and 9.2 million of those fall into the mild or moderate category. Under the rules being proposed in North Staffordshire, several million people would now not qualify for hearing aids.
Hearing loss at mild or moderate levels can have serious effects on people’s lives. Hearing certain speech sounds becomes impossible which in turn makes speech muffled and unintelligible. Withdrawal from social situations is often a result and contributes to strong feelings of isolation. Hearing loss has also been linked to mental illnesses such as depression or dementia.
Despite this, the vast majority of people considered to have a hearing loss do not use hearing aids. According to the same research, only 1.4 million people wear hearing aids on a regular basis and a further 600,000 have them but don’t use them; wasting hundreds of millions of pounds of public money.
Action on Hearing Loss is a charity that actively encourages people with hearing loss to get hearing aids as soon as possible. They have an online hearing test which will advise users to see their GP if any hearing loss is detected.
The charity’s Chief Executive Paul Breckell, said: ‘We are shocked to learn of North Staffordshire CCG’s plans to stop free hearing aids for people with mild to moderate hearing loss – these are exactly the people who need them most. The removal of this, a NHS provision, is unprecedented and we are deeply concerned that there will be further cuts to come.
“Hearing loss is a serious health issue, which, if ignored or unmanaged, can lead to isolation, dementia and mental health problems. Hearing aids offer a lifeline to many, especially older people with hearing loss who would otherwise be sat at home alone unable to communicate with the outside world.
“We are urging local people and health care organisations to voice their concerns by responding to the North Staffordshire CCG consultation and to attend meetings that the local CCG has organised in order to help counter these baffling and ill-thought-through plans.”
Dr Dave Hughes, a GP and Clinical Accountable Officer for North Staffordshire NHS said: “We think it is vital that we have this conversation with local people and that all interested parties have the opportunity to be fully informed over costs and the clinical needs of patients who do not have severe or profound hearing loss.
“This is not a formal consultation,” he said. “No decisions have been made and nothing is set to change imminently, but we want to make sure the public have the chance to tell us what they think.”
The annual budget for North Staffordhire NHS is £267 million and the predicted saving from the cut is £1.2 million or 0.44% of the total budget.
There is no national clinical guidance on providing hearing aids for age-related hearing loss. The National Institute for Clinical Excellence (NICE) is tasked with approving NHS treatments but withdrew it’s guidance on hearing aid provision pending a revision in 2003 at the time digital hearing aids were being rolled out. That revision never took place leaving the door open, in the absence of national rules, for local Clinical Commissioning Groups to withdraw hearing aid services if they see fit.
Sylvia Webb is a volunteer working for elderly people with hearing loss. She has a profound hearing loss herself and recently her husband was fitted with his first pair of hearing aids. She says he should have got hearing aids sooner than he did.
“I know how important it is. Husband got his first hearing aids at 74 and is struggling to adapt. I was really surprised how difficult it has been for him so the sooner the better; especially after seeing my hubby’s struggle.
“It was a really typical situation but I was really shocked at how hard it was for him. Yes, they adjust so much easier if they start before they have lost too much hearing but leave it late and it’s just too painful and the aid goes in the drawer instead of in the ear!”
Lorraine Gailey, Chief Executive of Hearing Link, a charity that represents deafened people, thinks that health chiefs in North Staffordshire will withdraw their proposals once they have looked at the facts.
“The proposal by North Staffordshire CCG to cease supplying hearing aids to older adults with mild and moderate hearing loss in order to save costs is both concerning, and puzzling.” She said.
“It is concerning because there is overwhelming evidence that effective early management of hearing loss is associated not only with a better quality of life for older people, but also with a significant reduction in the risk of developing other health conditions such as depression, confusion and cognitive decline including dementia.
“It is puzzling for the same reason. The relatively low cost of providing hearing aids for mild and moderate losses is much less than the cost of providing care for these associated conditions – not counting the high social and emotional costs they bring.”
The connection between hearing loss and mental health conditions is a relatively recent discovery. Dr Frank Lin, an assistant professor at the Johns Hopkins University schools of medicine and public health said earlier in the year that hearing loss contributed to accelerated brain shrinkage in elderly people, which was evident through MRI scans.
He said: “Our results suggest that hearing loss could be another “hit” on the brain in many ways.”
“If you want to address hearing loss well, you want to do it sooner rather than later. If hearing loss is potentially contributing to these differences we’re seeing on MRI, you want to treat it before these brain structural changes take place.”
Groups representing people with hearing loss are said to be ready for action after a flurry of activity on Friday when the leaders of national charities and local groups agreed to work together. Convincing the North Staffordshire CCG that providing these hearing aids should continue, while millions of people with mild or moderate hearing loss apparently don’t feel they are necessary, will be one of the main challenges to overcome.
The North Staffordshire CCG are holding meetings on Wednesday 25th June 2-4pm in Newcastle-under-Lyme and on Wednesday 2nd July 6-8pm in Leek. To express interest in attending, please contact Janet Carr before Monday 23 June at firstname.lastname@example.org, on 0300 404 2999 extension 6852 or text 07702 518595. People can also respond to the consultation by completing a short survey.
By Andy Palmer, Deputy Editor.
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