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90% of CCGs in England 'don’t hold basic information needed to provide good hearing aid services'

Vital hearing aid services across England could be at risk because an overwhelming majority of Clinical Commissioning Groups (CCGs) - the local bodies responsible for commissioning and paying for NHS services - do not have the “bare minimum” information needed to be effective, according to new research conducted by charity Action on Hearing Loss. The report also highlights the vast disparities in hearing aid provision across England.

Action on Hearing Loss

The report, launched on 4 June, and entitled 'Valuing Audiology: NHS Hearing Aid Services in England', was compiled using data from Freedom of Information (FOI) requests the charity sent to all 195 CCGs in England. Of those who responded in full, just one in 20 (5%) knew how much they are spending on audiology, how many hearing aids they are fitting, and whether patients are satisfied with what they are receiving.

Dr Roger Wicks, director of policy and campaigns at Action on Hearing Loss, said: "These results demonstrate an alarming lack of oversight and accountability on the part of CCGs, which are entrusted with providing healthcare local populations across England need. Without what seems to be the very fundamentals of evidence-based healthcare commissioning – the most obvious of which is rigorous data collection – 94.6% of CCGs are displaying a grave failure in basic budgetary and service management. Without data on how many people are being treated for hearing loss or on the quality of services, commissioning for audiology in many parts of England is being done through apparent guess work, and we fear that under pressure CCGs may well continue to see hearing aid services as a soft target for cuts.”

The charity actively campaigns against cuts to NHS hearing aid provision, and has successfully persuaded 14 out of 15 CCGs not to go ahead with proposed restrictions. The new report, however, has identified three CCGs that are currently deliberately choosing to restrict access to hearing aids. North Staffordshire CCG, Dorset CCG and Cambridgeshire & Peterborough CCG all require a high threshold of hearing loss before hearing aids are provided, which means that hearing aids are not provided to all those who would benefit from them. This is contrary to NICE guidance which states that provision of hearing aids should be based on need, not threshold alone.

Roger continued: “Such a systemic lack of oversight on hearing aid services sadly seems to demonstrate that CCGs are still not taking hearing loss and its wider health implications seriously. Hearing loss is linked to a significantly increased risk of dementia, isolation and other mental health problems. Hearing aids are a lifeline for people who use them, and are prohibitively expensive for the vast majority of people when bought privately. NHS hearing aids enable people with hearing loss to remain engaged with their families and their work life, and it’s vital that they remain available. Until CCGs take steps to collect fundamentally important data on the services they are commissioning, these services remain exposed to risk of cuts and rationing.”

The charity’s report lists a number of recommendations for CCGs, including at minimum collecting accurate data on audiology spend, access rates, number of hearing aid fittings, waiting times and outcome measures. It also calls on NHS England to stipulate that this data should be consistently collected and centrally published.

David Welbourn  CEO BSHAA

Responding to the Action on Hearing Loss report, BSHAA chief executive Prof David Welbourn said: "BSHAA - the professional body for independent audiologists - welcomes the work to shine a spotlight on the urgent need for many of the old myths about hearing care to be overturned. It is now recognised that untreated hearing loss is ranked as the fourth largest burden of disability in the UK, higher even that diabetes. Recent research has shown that addressing hearing loss is the single most significant action an individual can take to reduce their risk of dementia, and evidence continues to grow that hearing aids provide exceptional value for money, contributing strongly to wellbeing and fulfilment. Most hearing aid wearers wish they had taken action earlier.

"However, in making such an important contribution to promoting the importance of better access to good hearing care, it is disappointing to see Action on Hearing Loss undermining their own argument by reinforcing another outdated stereotype about the cost of hearing aids rather than stressing the valuable contribution to quality of life."

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