Campaigners are accusing the NHS
of imposing “cruel” cuts on people who are going deaf by denying them the hearing aids they need.
Growing numbers of NHS organisations are planning to ration access to the devices, even though they help to combat dementia, depression and social isolation among the hard of hearing.
Three of England’s 211 GP-led local clinical commissioning groups (CCGs), which fund treatments, are already facing heavy criticism after announcing they intend to restrict the numbers of hearing aids in order to save money.
The Northern, Eastern and Western Devon CCG has decided to provide only one hearing aid to those who have hearing loss in both ears, even though they need two. And CCGs in North Staffordshire and Kernow in Cornwall are introducing eligibility criteria that will deny hearing aids to those with mild to moderate hearing loss.
New research shows that 22 other CCGs either plan to follow suit or are considering making changes to their audiology services that could hit the hearing-impaired.
Freedom of information requests submitted by the charity Action on Hearing Loss show that five CCGs – in Brent (north London), Trafford (Manchester), Gateshead, South Tyneside and Telford and Wrekin – are looking into “decommissioning” some audiology services.
NHS Brent, for example, said it was reviewing what it called non-complex audiology service pathways, including hearing aids and hearing assessments. Eleven other CCGs are reviewing the commissioning of such services, but said no decision had been made.
Six other CCGs said they planned to review the commissioning of audiology services and left open the possibility that this could lead to fewer aids.
“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,” said Louise Hart, of Action on Hearing Loss.
“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.”
The findings are part of an investigation by the charity into whether the NHS is restricting access to hearing services.
Dr Roger Wicks, of Action on Hearing Loss, said there could be a “domino effect” of such cuts among CCGs. “Hearing aids have been free on the NHS since its creation in 1948, and this is the first time routine provision has come under threat. It’s driven by the need to cut costs and has nothing to do with people’s health needs,” said Wicks.
An estimated 10 million people in the UK have some hearing loss, although that is likely to rise to 14.4 million by 2031. About 2 million mainly older people have hearing aids, 84% of whom got them from the NHS. Hearing tests cost the NHS £49; a test and fitting of one aid is £294; and fitting two aids is £388. The one in seven people who end up getting hearing aids from a private provider pay on average £3,000 for a pair.
The Department of Health
declined to comment, but NHS England, which gives CCGs £66bn a year of its £96bn budget to spend on care and treatment, said that people who are hard of hearing should get the help they need.
“Although commissioning decisions are the responsibility of local NHS commissioners, hearing loss can have a profound effect on an individual’s health and well-being and it is important that people have access to appropriate care.”
However, NHS Clinical Commissioners, which represents CCGs, defended individual CCGs’ right to make “difficult decisions” about what to provide.
Dr Steve Kell and Dr Amanda Doyle, its co-chairs, stressed in a statement that CCGs’ “increasingly squeezed finances” were a major challenge.
“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”, they added.