28 June 2014

A pathway through better hearing services

There are some simple steps the government and health commissioners can take to improve hearing care pathways.

In evidence to the ILC-UK Commission on Hearing Loss recently the NCHA and BSHAA put forward four proposals which would immediately improve commissioning of hearing services across the board.

• a National Commissioning Framework for Hearing along the life journey to support CCGs
• cost-effective NHS, social care and voluntary sector pathways at all points within the Framework
• an unremitting focus in commissioning on outcomes and quality (as measured by patients and their families) at all points, rather than activity or hearing aid fittings
• simple hearing needs assessment tools to enable CCGs to plan and commission services across the life journey for their local populations.

Finding the right path

The AQP pathway has been a very good start for age-related hearing decline. Others are needed across the hearing life journey to help commissioners plan and commission what needs to be delivered.

It will come as no surprise to front-line commissioners and providers that care can be planned for on a population basis with a reasonable degree of accuracy.  Even more volatile areas of demand such as A&E can be planned for.  It is not by chance that the ambulance services station their teams where history has shown they are going to be needed (even the Friday and Saturday night casualty blitzes are predictable.)

For hearing, with even basic demographic information, this is far simpler.  The key is to have a good working estimate of prevalence at each stages of the life journey and then plan to deliver services to meet this a) at the highest quality, outcomes and convenience for patients, b) in the most timely and appropriate way and c) at the lowest price.  It is not rocket science.

The path to success

If commissioners, providers and patient groups work together at national and local level this can all be achieved relatively simply and, even while we still have a little time, before further budget cuts are imposed.  Such a framework will also prevent commissioners following misleading pathways.

The final challenge is for the sector itself to lead this work.  No one else - in CCGs, at NHS England or anywhere else - will have the enthusiasm, time, interest or commitment to see it through.

Nothing highlights more the urgent need we have to work together than the recent difficulties in North Staffordshire. The challenges the NHS faces are real and it is only by working together that we can deliver a sustainable solution for commissioners, providers and the patients we all serve.

This blog is the second in a series looking at commissioning more effective hearing services using care pathways by NCHA chief executive David Hewlett. Read the previous instalment: A pathway to better hearing services

You can now also access local data using the NCHA hearing map.