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North Staffordshire CCG

NHS England will not stop hearing aid ‘rationing’ plan

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NHS England will not intervene in a clinical commissioning group’s attempt to ‘ration’ access to hearing aids, LGC’s sister title Health Service Journal can reveal.

  • NHS England area team refuses to intervene in North Staffordshire CCG “rationing” plans
  • Measures will save £200,000 and affect 500 people
  • Charity claims CCG’s plans breach statutory duties and sets “damaging” precedent

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The national body’s North Midlands area team said it supported North Staffordshire CCG’s plans, which will restrict access to publicly funded hearing aids for the first time in NHS history. It said the group had followed “proper process” and made an evidence based decision.

This has been disputed by a hearing charity, which warned that neighbouring CCGs could be poised to “follow suit” with similar plans.

In March North Staffordshire approved proposals to stop routinely funding hearing aids for patients with hearing loss between 26 and 40 decibels – classed as “mild”.

Those with “moderate” hearing loss of 41-55 decibels would only be eligible for an NHS funded device if they scored sufficiently highly in a “functional impact assessment”.

The plans, which are aimed at saving the CCG around £200,000 annually and will affect 500 new patients a year, are due to take effect from October.

They have been vigorously opposed by the charity Action on Hearing Loss, which said the measures could increase isolation, mental health problems and dementia, while forcing patients to spend “thousands of pounds” on private medical bills.

The charity sent a letter to the North Midlands area team last month urging it to “investigate the CCG under its CCG assurance duties” and stop the “damaging policy”.

The letter claimed the decision contradicted the CCG’s duties under the Health Act 2012 and the NHS constitution, as well as various national and local strategies.

Hearing test

A charity opposed to the plan says it will force patients to spend ‘thousands of pounds’ on private medical bills

It said the CCG had breached its duties to make decisions after “a proper consideration of the evidence” and with “effective participation of the public in the commissioning process”.

The charity claimed North Staffordshire had disregarded “robust evidence” showing the benefits of hearing aids, and had only carried out an “engagement exercise” rather than a full public consultation.

“Despite removing the provision of hearing aids for two-thirds of people who currently receive them… the CCG has not held a public consultation nor involved patients or the public in the decision making process,” the letter said.

Earlier this month the area team told Action on Hearing Loss that NHS England would not intervene.

Samantha Milbank, NHS England’s interim locality director for the North Midlands, told HSJ the area team “supported the CCG’s decision… having been assured that proper process had been followed by the CCG, the commissioning policy is evidenced based and there had been extensive engagement in developing policy”.

“This policy only affects those people with mild to moderate hearing loss and specifically excludes people affected by hearing loss with other conditions such as hearing loss since childhood, tinnitus or dementia,” she added. 

Ms Milbank said the plans were different to service restrictions proposed by Northern, Eastern and Western Devon CCG last year which included restricting funding to one hearing aid. The plans were opposed by NHS England chief executive Simon Stevens and subsequently dropped.

Ms Milbank said the Devon proposals were different because they involved “a set of more sweeping restrictions”.

Action on Hearing Loss chief executive Paul Breckell said people in North Staffordshire had been failed “at every step by the health service they pay for”.

“With suggestions that other CCGs in the area will follow suit, people in North Staffordshire are being hardest hit by increasing variations in local healthcare provision,” he said.

“NHS England must not ignore its duties under the [Health Act] and the national government strategy, the Action Plan on Hearing Loss, to investigate, intervene and stop this ill thought through new policy.”

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