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 nfo@staffordshirecss.nhs.uk, 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.
Andy is Chairman of the Peterborough and District Deaf Children’s Society and teaches sign language in primary schools. Contact him on twitter @LC_AndyP
The Limping Chicken is the UK’s independent deaf news and deaf blogs website, posting the very latest in deaf opinion, commentary and news, every weekday! Don’t forget to follow the site on Twitter and Facebook, and check out our supporters on the right-hand side of this site or click here.
Befuddled.
June 8, 2014
Don’t older people matter then?
I for one happen to respect and value our older generation. During the week we commemorate the D day landings too. An utter disgrace. What is happening to this country? Get the Tories out!
M
June 8, 2014
Ignorance is still within the NHS and might the “Sick of It” report be failing those client group once again, since d/Deaf UNITY and making the report holistic has failed to educate CCG what deafness and diversity means. It is not just about BSL a language in its own right. Again society abusing the older generations. Will they next be stopping the supply of walking stick for the ambulant difficult?
Helen jones
June 8, 2014
As an ex NHS audiologist now living and working in Australia, i cannot understand the mentality of the people who make these decisions now nor could I 13 yrs ago when I left. How deaf is deaf enough politically to warrant hearing aids. As the experts we should make those decisions not politicians. Will they decide on who should have surgery by how sick they are; spectacles by how blind you are or a blood transfusion by how anaemic you are? No, they will allow the medical specialists to make that decision, and so they should audiologists not the bean counters.
cherry
June 8, 2014
This is in conflict when increased access to correct listening devices is under review by NHS England itself and the House of Lords Commission. Recent reports including the recent Sick of It report, demonstrate poor health due to poor COMMUNICATION. Its been already estimated NHS could save £30 million pa if Deaf/hard of hearing had same health profile access as general population. Communication is key. Hearing aids are part of communication access. Value For Money (VFM) and Return Of Investment (ROI) requires improvement to the follow up on how to get best use from assisted hearing devices to finely retune to enhance sounds we process. Its that area of service which is lacking, is a huge void in many audiology units and as a result many aids remain in their boxes instead of of providing essential benefits.
This CCG is looking short term rather than long term – we already know the NHS is bankrupt and we are all doing what we can to look at costs but not to this detrimental short sighted not thought through and suspect incorrectly evidenced rather than looking at what is currently being reviewed and all recent reports.
Hartmut
June 8, 2014
That is clearly the decision amking of IDIOTS who know nothing about those who can benefit from hearing aids. They are cheaper than a CI and a digital hearing aid. They are following the generalization phantom. Not everyone fit a preconceived pattern. A pattern is NOT a pattern as long it is preconceived and according to statistics.
Those who determine no HA are Assholes.
Hartmut
June 8, 2014
More: Why are those in the decision-making process allowed to make those inane decisions? THEY OUGHT TO BE FIRED !
pennybsl
June 8, 2014
It is shocking news.
Deaf adults do not always have the adequate support and information regarding using hearing aids, their deafness is a medical issue in today’s clamouring world.
I was saddened to discover a close relative, after poor support by the local NHS Audiology service concerning his deafened condition and not getting any benefit from the NHS hearing aids, decided to go private and squandered a few thousand pounds of very hard-earned savings for hearing aids.
We had thought, this is 2014, it could not be right that those small plastic covered gadgets could still be costed so much especially as my relative has moderate hearing loss.
Robert
June 8, 2014
Disgraceful! This would undoubtedly be the thin end of the wedge, eventually resulting solely in private provision of hearing aids, coupled with the traditional private sector rip-off prices. If the NHS wants to save money, they should focus attention on recovering the hearing aids which are issued but not used.
Andy, not him, me
June 8, 2014
I am glad that at this stage they are only considering it. Some things they might like to consider too…
Just because someone has a lower degree of deafness it doesn’t mean that they have an easier life or that they do not need as much support as severely deaf people. Who gave them this idea?
Loneliness and isolation are known factors in both elderly and deaf people, not necessarily associated with the level of hearing loss. When the elderly are also deaf then logically there should be more support, not less. More hearing aids not fewer.
It is very short sighted to consider cuts in this area where there is currently a growing need. The social repercussions of dealing with all this isolation and loneliness will amount to a lot more than the cost of supporting hearing loss in the first place.
As far as people not using their hearing aids are concerned … are these people getting proper aftercare? Or are they just being turned out and left to get on with it? I suspect the latter.
New hearing aid users need support, the NHS isn’t providing it. The hearing aids go in the drawer because only half the job is being done. This is an area that needs expansion, not cuts.
Emily
June 8, 2014
If the NHS is no longer willing to help individuals with age related hearing loss by providing them with free hearing aids ( which I believe costs the NHS around £80 each due to having a contract for big orders that makes them cheaper in comparison to private hearing aids which can cost individuals over £3K each), then the cost of supporting these deafened individuals in terms of the cumulative effects of their inability to access communication and services through lack of medical equipment will rise steeply and ultimately other services will have to dig deeper in their pockets to provide support to these people and where would these cuts end, other NHS cuts will surely follow if this is allowed to happen?
Liz
June 8, 2014
I can’t even believe they are thinking this! As said here already, just how far do cuts go if they did this? I am profoundly deaf, but I remember those tears ago when I first got my hearing aids as a moderately deaf person, just how much of a god send my hearing aids are to me. Although I wear hearing aids and still have difficulty, without it would be so much worse. I would not be independent as I am now. Getting my confidence back has took me a long time to where I am now. Take my hearing aids away, I would loose my independence, feel isolated, loose confidence. This would then lead to depression and anger and more. This in turn would cost the NHS more money because of people’s mental health.
My Mum would be affected if the decision to cut hearing aids and stop people who have mild to moderate hearing loss from having hearing aids. It took me a long time to persuade my Mum to wear hearing aids. Now she has them, she wish she wore them sooner. My Mum feels better wearing them and I see a difference. All improvement in her health would be taken away f she lost her hearing aids.
Nathan
June 8, 2014
I cannot help but notice the soaring growth of hearing aid shops/clinic – every Boots and Specsavers seem to have hearing aid clinics nowadays.
Is there a link? Are they trying to make audiology services like an optometrist shops do nowadays? There are many optometrists around like vision express, boots, Specsavers etc that did not even exist like 10-15 years ago!
It looks like to me, the NHS is trying to spin off audiology onto the private sector and make the general public pay for it much like Specsavers and Boots – I think GPs can actually refer people to Boots or Specsavers for hearing aids.
However, for people who , like me, are profoundly deaf – would Boots/Specsavers be capable of meeting our needs?
Tim
June 9, 2014
The NHS was privatised by the ConDem government in their recent Health and Social Care Act, it just hasn’t been reported. There will be a lot more of the same and it won’t be pleasant.
BAA President
June 9, 2014
The British Academy of Audiology (BAA), the UKs largest professional body representing over 2000 professionals working in the field of hearing and balance would like to make it clear we condemn any such proposals that would prevent a hearing impaired person accessing a hearing aid free at the point of care. We at the BAA are working hard with our colleagues to ensure the CCG will be furnished with enough evidence to help them understand the real impact of such proposals. As we professionals know , mild to moderate hearing loss does not equate to mild to moderate problems and the degree of disability caused by hearing loss cannot be quantified by the degree of hearing loss. So in essence what is important though is the patient voice comes across loud and clear to commissioners that they oppose these proposals.
cherry
June 12, 2014
Thank you to BAA president for your comment above an commitment. Here is a suggestion for the CCG to read http://www.the-ncha.com/news/how-to-commission-adult-hearing-care-a-practical-guide/