Written evidence from The Royal National
Institute for Deaf People (CFI 20)
1. We're the RNID, the charity working to create
a world where deafness or hearing loss do not limit or determine
opportunity and where people value their hearing. We work to ensure
that people who are deaf or hard of hearing have the same rights
and opportunities to lead a full and enriching life. We strive
to break down stigma and create acceptance of deafness and hearing
loss. We aim to promote hearing health, prevent hearing loss and
cure deafness.
2. We have answered specific questions where
appropriate:
The Committee believes it is essential for clinical
engagement in commissioning to draw from as wide a pool of practitioners
as is possible in order to ensure that it delivers maximum benefits
to patients. The Committee therefore intends to review the arrangements
proposed for integrating the full range of clinical expertise
into the commissioning process. (Paragraph
96)
3. RNID strongly agrees that it is essential
that the full range of clinical expertise is integrated into the
commissioning process. Moreover, we are concerned that GPs have
low understanding of the needs of people who are deaf or hard
of hearing. Evidence suggests that GPs fail to refer up to 45%
of people reporting hearing loss,[58]
highlighting major issues in terms of access to services.
4. It is only possible to secure the best treatment
options for your patients if you are also fully aware of relevant
development in technology, clinical procedures and models of service
delivery, and we have evidence that GPs are particularly lacking
in current awareness of treatment options, additional services
and referral criteria in audiology.
5. Therefore, we would like to see audiology
and hearing loss champions, sitting within every local authority,
responsible for capturing relevant developments in technology,
clinical procedures and models of service delivery and for keeping
GPs fully aware of these. These champions will also look to promote
and publicise best practice in terms of hearing service provision
to ensure that the needs of people with hearing loss are met.
We would also like to see some GP consortia becoming centres of
excellence in specialised areas including audiology and hearing
loss and the NHS Commissioning Board playing a fundamental role
in identifying and disseminating good practice.
6. We understand that the NHS Commissioning Board
will have a key role in providing expert advice to commissioning
consortia. We therefore welcome amendment 114 to the Bill. This
probing amendment uses audiology and hearing loss services as
an example to explore how wide reaching the duty on the Board
to seek expert advice will be and to seek clarification that the
Board will produce advice for consortia on all conditions they
will be responsible for commissioning services for.
7. Decisions around the commissioning of services
will be informed by both specialist clinical knowledge and information
around the needs of the local population as captured in the Joint
Strategic Needs Assessment. However, we looked at a small sample
of these and found that they did not take account of hearing loss.
Therefore these do not currently reflect the needs of the whole
population. RNID would like to see more robust national guidelines
introduced so that JSNAs capture the needs of every person.
The commissioning of services that either work
across [health and social care] boundaries, or are intimately
linked is therefore an issue to which the Committee attaches great
importance, and we intend to review the effectiveness of the structures
proposed in the Bill which are designed to safeguard co-operative
arrangements which already exist and promote the development of
new ones. (Paragraph 107)
8. Good outcomes in audiology and hearing loss
services depend on access to information, signposting and demonstration
of other assistive technology, typically funded by local authorities.
9. RNID believes that current delivery of health
and social services is not sufficiently joined-up. A recent survey
showed that 79% of people, when fitted with a hearing aid, received
no information about other services or that would maximise their
independence and wellbeing.[59]
We are concerned that this kind of partnership will be harder
under the new arrangements because the commissioning units may
no longer cover the same areas as local authority boundaries.
10. We would welcome the opportunity to discuss
these issues further with the Committee.
11. We have also attached our response to the
Department of Health's consultation around Commissioning for Patients.
February 2011
58 Davis, A et al (2007) "Acceptability, benefit
and costs of early screening for hearing disability: a study of
potential hearing tests and models" (Health Technology Assessment
2007; Vol. II: No. 42) Back
59
RNID, Annual Survey, 2008. Back
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