What do you think are the main patient and commissioner benefits of a community-based adult hearing service and what differences do they make to commissioners’ population groups?
For patients, community-based hearing care services provide a greater accessibility and flexible appointment times. At Specsavers, patients can be seen within nine days of being referred by a GP, on average. Also, importantly, it helps to remove the stigma of wearing hearing aids by taking treatment out of the hospitals and onto the high street. Typically, our patients do not see hearing loss as an illness, so treatment in a community setting is welcomed. Furthermore, with walk-in access to unlimited aftercare, patients are more likely to adapt to, and continue to use, their new hearing aids, rather than abandon them out of frustration or a lack of access to immediate aftercare.
How has the commissioning of community-based hearing services been going?
All areas are performing particularly well with high numbers of GPs referring patients. Clinical commissioning groups (CCGs) are committed to delivering a localised, non-medical service and GPs recognise that a non-medical intervention which patients can access in a high street setting, with unlimited access to aftercare, does improve outcomes.
We have found that once they have information on the nature of age-related hearing loss, GPs are open to change to improve patient service. GPs recognising that age-related hearing loss is a condition that will come to us all – rather than an acute or chronic illness – has led to a view that commissioning community hearing services is much less contentious than many of the other changes happening across our NHS
. This is a condition best solved outside of the hospital.
We are aware that in a period when one of the most complex organisations in the world is undergoing the most significant restructure since its inception, CCGs have had to prioritise other services. It is our job, and the job of organisations such as the National Community Hearing Association, to ensure that commissioning adult hearing services provides a quick win for CCGs, for GPs and, most importantly, for patients and the local community.
What is the economic impact of age-related hearing loss?
In 2010-11, NHS England spent £450m managing hearing problems, a figure that will inevitably increase as the population ages. There are also long-term costs that need to be considered as comorbidities begin to develop.
So, for example, age-related hearing loss increases the risk of depression, dementia and falls. Treating depression costs the NHS more than £520m a year: £237m for hospital care, £230m for antidepressants, £46m for outpatients’ appointments. Preventing depression by addressing hearing loss, as well as other risk factors, will help reduce the clinical and economic burden imposed by depression.
What four key points would you make to commissioners to help them offer the best service possible for their population groups?
Firstly, consult with patients and look at what the deliverables are for the patient outcomes.
Secondly, take a look at the service you are providing and ask yourself what is the opportunity to meet saving requirements, while still driving quality outcomes upwards.
Thirdly, read the Hear and Now report, which explores the economic, physical and psychological impact of age-related hearing loss and challenge yourselves and your providers to ensure you are making as many savings and efficiencies as possible in other areas, as well as audiology, which will ultimately benefit your patients.
And finally, commissioning age-related services in the community is relatively simple and a straightforward process that can deliver real savings and real benefits to the local community.
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