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CCGs cut back on audiology services



CCGs have come under criticism from hearing loss campaigners over plans to ration hearing aids and introduce other cutbacks to services.

Three commissioning groups – NHS Northern, Eastern and Western Devon (NEW) CCG, NHS North Staffordshire CCG and NHS Kernow CCGs – are have put forward plans to tighten restrictions on hearing aids, while a further five CCGs have said they are considering decommissioning audiology services.

Charity Action on Hearing Loss described the cutbacks as ‘cruel’, but GP commissioning leaders said CCGs had to make ‘difficult decisions’ about health needs.

Last month NHS Northern, Eastern and Western Devon CCG announced it was still considering a plan to restrict people to just one hearing aid as part of a range of cutbacks aimed at tackling a 14.5 million deficit – although commissioners back-tracked on other proposals to block smokers and obese people from undergoing routine surgery.

Two other CCGs – North Staffordshire and Kernow – are also consulting on plans to tighten up eligibility criteria for hearing aids so that people with mild to moderate hearing loss are no longer entitled to them.

And according to an investigation by Action on Hearing Loss, several other CCGs are now looking at cutting back on services for people with hearing loss.

In responses to the charity’s Freedom of Information requests, five CCGs said they are considering decommission audiology services to save money, while a further 17 CCGs are reviewing or planning to review commissioning of audiology services.

The charity said this reflected a ‘worrying trend’ and that denying patients appropriate management for hearing loss could lead to dementia or worsening mental health problems.

Louise Hart, from Action on Hearing Loss, told the Guardian newspaper: ‘To deny somebody the right to a good quality of life – the opportunity to be an active member of the community, interact with family and friends, or even to continue working – is akin to saying to someone, “I can make your life better by giving you hearing aids but I’m not going to”. It’s wrong, it’s cruel.’  

She added: ‘If you have hearing loss but don’t have hearing aids, you are more prone to depression. My patients often tell me they no longer go to social activities because they can’t hear any more.’

In a joint statement to the paper, Dr Steve Kell and Dr Amanda Doyle, co-chairs of NHS Clinical Commissioners, said: ‘Hearing aids and audiology services are part of the whole package of care services that patients can access, and with an ageing population comes an increase in demand for services like hearing aids, so it is right that CCGs look across local audiology pathways and review the existing costs and services.”

‘Clinical commissioners have to make difficult decisions about service provision on a daily basis but their first priority is to their patients and where possible will want to give them what they need, and that includes hearing aids.’

In a statement to Pulse, Dr Rob White, NHS Kernow CCG’s clinical lead for elective care, said: ‘Like all commissioners, we must ensure our services meet demand and provide value for money. No decision has been made about making changes to the adult hearing service and we are now asking the public, clinicians and stakeholders for their views on our proposals. We are working with clinicians, including audiologists, to ensure that any changes to the service – including any possible introduction of a clinical threshold – are based on clinical evidence and comply with health and equality regulations.’

NHS North Staffordshire CCG said its Clinical Priorities Advisory Group (CPAG) had been carefully analysing feedback and additional evidence from its public engagement on the proposals. 

CCG chair Dr Mark Shapley said: ‘The next step for the CCG is to produce a commissioning policy to specify eligibility criteria for hearing aids which reflects the CPAG findings, the local population needs, the learning from our engagement and our financial position.

‘This will be taken through a quality impact assessment and an equality impact assessment. It will then be presented to the Commissioning, Finance and Performance Committee next year for discussion and debate.’