Select Committee on Health Written Evidence

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.


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.


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.


    —  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


9 February 2007

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