More deaf people to qualify for NHS cochlear implants as guidance updated

Guidelines on funding for cochlear implants on the NHS have been changed, meaning potentially up to 850 more adults and children whose hearing loss cannot be sufficiently remedied by standard hearing aids will become eligible.

The update follows a review of the definition of severe to profound deafness, used to assess whether someone qualifies for a cochlear implant.

The previous threshold has been lowered so that severe to profound deafness is now acknowledged as only being able to hear sounds at 80dB HL and above at two or more frequencies without the help of hearing aids. (Formerly, the level for qualifying for an implant was 90dB HL.)

Guidance has also been changed to include a more accurate hearing test to assess adults’ hearing function.

The National Institute of Health and Care Excellence (NICE), which assesses the cost-effectiveness of NHS treatments, says that where differing cochlear implant solutions are felt to be equally effective, the least expensive system should be chosen.

At the same time, cost assessments should incorporate factors such as long-term dependability and the support package on offer.

For profoundly deaf children, and adults with a further disability such as blindness, and children, who do not benefit enough from acoustic hearing aids, NICE recommends simultaneous bilateral cochlear implantation.

Those who now qualify for a second cochlear implant under the new criteria are being urged to seek advice and discuss options.

The report adds that assessment must be done by a multidisciplinary team, and as part of assessments, an acoustic hearing aid should be trialled for at least three months first. Qualifying criteria were previously among the strictest in Europe.

The director of NICE’S Centre for Technology Meindert Boysen said: “This updated eligibility criteria ensures that implants continue to be available on the NHS for those who most need them.”

Meanwhile an audiologist at the National Deaf Children’s Society (NDCS), Vicki Kirwin, described the ‘incredible’ impact cochlear implants can have on the lives of deaf youngsters. She added: “With this updated guidance, Britain will go from having some of the strictest criteria in the developed world for cochlear implant assessment to being at the forefront of giving this technology to children.”

With the average NHS cochlear implant costing up to £15,600, the UK has more than 613,000 people aged over 16 with profound or severe deafness. The updated criteria follows a petition and a campaign in which the charity Action on Hearing Loss played a key role.

The petition was launched by a cochlear implant user from Rotherham Diane Matthews, whose story featured in Limping Chicken a year ago.

She told journalists: “I am over the moon to hear that this much-needed change is finally here. This has been due to the tireless work of many people, professionals, researchers and patients included.” She adds that her implant has been life-changing after living with hearing loss for two decades.

Action on Hearing Loss was part of the Action Group which gave evidence to NICE, and funded research and worked with Jim Fitzpatrick MP, chair of the all-party parliamentary group on deafness, to stage a parliamentary debate on this issue last year.

The organisation’s Dr Roger Wicks, director of policy and campaigns, described the new criteria as “huge step forward for people with severe to profound hearing loss.”

He added: “Many more people will now be able to enjoy the benefits of this treatment. Research shows that cochlear implants may benefit people with lower levels of hearing loss. This has meant that many people have had to wait for their hearing to get worse before they can have access to this transformative treatment.”

Alex Orlov, 39, who had a cochlear implant fitted eight years ago, said: “Criteria for implants have been relaxed several times over the years but I welcome this latest one, and making implants accessible to more people. Having the implants has definitely changed my life for the better. I wouldn’t go back to hearing aids as they don’t help me. To put it in perspective, in Israel, where I’m from, the threshold is set even lower at just 70 90dB HL.”

One person got in touch anonymously via Facebook to say: “I’ve been severely-profoundly deaf since I was around six. My hearing has deteriorated over the years and I was always told I’d never be eligible for a cochlear implant, despite having severe-profound deafness in both ears. I had always relied on NHS hearing aids, but up until about two or three years ago, I switched to private hearing aids because the service with NHS audiology and the quality of hearing aids was so poor compared to my private ones. “I had always considered a cochlear implant but I’ve known a few people who got one and are now suffering complications. This makes me doubt whether I want one. “It’s great they’re changing the criteria, but they need to support current users with potential issues.”

Another Facebook user, Aaron Makepeace, got in touch to say: “I have a problem with the way they came to this decision rather than the decision itself. Implants don’t work for everyone, and those who have this single option forced on them will struggle regardless. The appraisal and decision confirmed to me the complete disregard of sign language as a viable means of communication.”

The most up-to-date statistics from NICE, for 2008, show that in that year more than 700 children and adults received a cochlear implant.

By Juliet England. Juliet England is a hearing-impaired freelance writer.