Evidence submitted by Sense (AUDIO 41)
1. Sense is a national charity that supports
and campaigns for children and adults who are deafblind. We provide
specialist information, advice and services to deafblind people,
their families, carers and the professionals who work with them.
In addition, we support people who have sensory impairments with
additional disabilities.
2. Sense welcomes the opportunity to submit
evidence to the Health Committee short inquiry into audiology
services in England. All NHS audiology departments in England
have now reformed their hearing aid services through the Modernising
Hearing Aid Services (MHAS) programme, and are fitting digital
hearing aids and this is therefore a very timely enquiry.
RESPONSES TO
THE COMMITTEE'S
QUESTIONS
Whether accurate data on waiting times for audiology
services are available?
3. The Government has excluded digital hearing
aids from the 18 week patient pathway from GP referral to the
start of treatment. Information on waiting times for hearing aid
fittings and local funding for provision of digital hearing aids
is therefore not collected nationally.
4. The Government has said that it aims
to deliver audiology diagnostic tests within 13 weeks by March
2007, and within six weeks by December 2008. However, this target
applies to diagnostic tests, not the fitting of hearing aids.
The decision to exclude direct referrals from the 18 week target,
while including referrals made through ENT consultants, creates
an incentive for patients who know the system to ask to be referred
to a consultant in order to receive a hearing aid within 18 weeks.
Sense recommends that direct referrals for digital hearing aids
should be brought within the 18 week target.
Why audiology services appear to lag behind other
specialties in respect of waiting times and access and how this
can be addressed?
5. Hearing aids improve people's quality
of life, and this is particularly true for people with dual sensory
impairments. However, not being able to see or hear clearly is
not life-threatening, and this may be one reason why audiology
services have lagged behind other specialities.
6. However, Sense believes that quality
of life issues should be given priority by the health service,
not least because of the impact they have on patients' wellbeing
and ultimately on their overall health. For example, deaf, deafened
and hard of hearing people are vulnerable to isolation and depression,
and access to a digital hearing aid can help to overcome isolation.
7. For people with a dual sensory impairment,
access to a digital hearing aid can also make an enormous amount
of difference to their independence—this can be as simple
as enabling them to cross the road in safety. Maintaining a person's
mobility and continued integration with the community will benefit
both their physical and mental health. A long delay will make
reintegration very difficult for an older person, leading to reduced
independence and greater potential cost to health and/or social
services.
Whether the NHS has the capacity to treat the
numbers of patients waiting
8. It is difficult to make a judgment as
to whether the NHS has sufficient capacity because there has been
no investigation of the potential demand for audiology services.
Sense recommends that any assessment of the potential demand for
audiology services should take account of the needs of the ageing
population, especially as the most common cause of sensory impairment
is old age (55% of people over 60 are deaf or hard of hearing).
How great a role the private sector should play
in providing audiology services
9. The important thing for people receiving
audiology services is that they get the service they need, including
follow-up appointments to tune the hearing aid to their requirements.
So it is vital that if services are commissioned from the private
sector, customer satisfaction is carefully monitored, as well
as throughput.
10. Any private sector organisations providing
audiology services on contract to the health service must have
appropriately qualified and experienced staff, and the service
must comply with nationally agreed standards and be subject to
external quality checks. There must also be an effective complaints
procedure, and the availability of this needs to be advertised.
ADDITIONAL ISSUES
Priority for digital hearing aids
11. There have been no changes to the national
guidelines for fitting digital hearing aids since digital hearing
aids first became available free on the health service in September
2000. There are guidelines issued by the Modernising Hearing Aid
Services (MHAS) programme, but the use of these is subject to
local clinical discretion. Under the MHAS eligibility guidelines,
patients who receive a war pension, are registered blind or are
considered to have special clinical needs are given priority.
12. Many PCTs also prioritise people with
visual impairments, not just those who are registered blind. For
example, Sedgefield PCT's policy is that "vulnerable patient
groups, such as the registered partially sighted, war pensioners
and terminally ill, are fast tracked".
13. Sense recommends that there should be
national guidance for priority for digital hearing aids. This
should state that anyone who has a visual impairment in addition
to their hearing impairment should be prioritised. At the same
time, we would like to see urgent measures to reduce waiting times
overall, so that the need for prioritisation of some groups above
others becomes less.
SUMMARY OF
RECOMMENDATIONS
— Digital hearing aids should be brought
within the 18 week patient pathway target.
— Any assessment of the potential demand
for audiology services should take account of the needs of the
ageing population.
— National guidance on priority for
digital hearing aids should state that anyone with a visual impairment,
not just those who are registered blind, should be prioritised.
Katie Hanson
Sense
9 February 2007
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