Health and Social Care Bill

Memorandum submitted by by the British Society of Hearing Aid Audiologists (HS 135)

The British Society of Hearing Aid Audiologists is the professional body representing hearing aid dispensers who are registered by the Health Professions Council and provide hearing care in the independent sector. The Society has 1,200 members, around 80% of all registered hearing aid dispensers in the UK.


1 We believe that people needing advice on hearing, and potentially hearing assistance should be able to access this non-medical NHS-funded care from any willing, qualified provider– where they want, when they want, from whom they want. Like other primary care services it should be available from as wide a range of convenient local centres as possible including hearing aid dispensers on the high street as well as specialist audiology clinics.

Supporting Statement

2 Most adults who have a mild to moderate naturally acquired hearing loss do not need to see their GP and then a specialist audiology/ENT service in a hospital clinic. They have no medical need: they are not "ill", they are not "deaf" but simply experiencing a natural and gradual reduction in their hearing ability as they get older.

3 if people are given real, informed choice, they will accept more responsibility for their own care and be more likely to wear their hearing aids so increasing the cost effectiveness of NHS-funded essential hearing care.

4 The wide availability of NHS-funded hearing care will raise awareness of hearing as a public health issue. Barriers to access and stigma will reduce. More people will access the service when they start to need it - and it can have most benefit – not when their hearing has declined to a point when rehabilitation and social and economic isolation have become major challenges.

5 There are huge hidden costs and consequences to untreated hearing loss including missed employment opportunities and general ill health and psychiatric disorders including depression.

6 Early, effective treatment of age-related hearing reduction is vital as the need to have people economically active, longer, increases in an era when noise-related hearing reduction will affect the "I-Pod generation".

7 The NHS should commission adult hearing care services nationally, to a nationally-set tariff; or at least with as much national quality and consistency as possible. Ideally the National Commissioning Board should be responsible for a national Primary Hearing Service (PHS) just as they are other family health services provided by a whole range of independent contractors.

8 Pending the necessary legislation, adult hearing services should be available from any approved willing provider on a national list who delivers to clear quality standards, service specification, outcomes and access criteria, within a national tarrif.

9 The excellent work done by the DoH in defining and standardising the national pathway for adult hearing care and developing patient-experienced outcomes and quality measures, should not go to waste.

10 Service users, commissioners and providers urgently need simple, effective and understandable quality standards because competition on quality and informed patient choice requires transparency, simplicity, clarity and comparability.

11 We do not believe that GP Consortia can be, need to be, or should be expected to be, effective commissioners of essential adult hearing services. It would lead to a postcode lottery.

13 They cannot be expected to give hearing care any priority in the face of major health issues such as heart disease and cancer; and in any case, evidence suggests that GPs are not good at dealing with hearing problems – up to 45% of people who go to their GP with a hearing problem are sent away without any help at all.

14 BSHAA is the professional body for 1500 Hearing Aid Dispensers, health professionals already well regulated by the Health Professions Council. They have a protected title within a function defined by legislation.

15 These dispensers work within national, regional and local companies and as independent practitioners and the vast majority of them participate in a sector-wide self-regulation scheme of consumer protection good practice.

16 They are experts in testing and assessing hearing and prescribing and fitting hearing aids if required - last year they fitted 200,000 instruments to paying customers - and the are the specialists who could complement the specialist audiology provision for more complex patients and appropriately provide the most cost-effectively quality service for the great majority of the 900,000 hearing aids fitted to NHS patients.

17 Dispensers are SMEs which can provide an innovative, user-driven, accessible, clinically safe and quality service to NHS patients. They welcome the opportunity to compete on quality and want to see clear national and transparent standards and tariffs against which patients can make informed choices and judgements.