05 March 2015

Monitor Hearing Care Review: Evidence shows CCGs can do more with less

Monitor’s review shows that higher standards can be commissioned at lower prices, allowing the NHS to see more patients within available resources.

The National Community Hearing Association (NCHA) welcomes the release of the NHS regulator Monitor’s review of adult hearing services. It shows that developing services in the community has improved access and allowed higher standards to be procured for patients at a lower cost to taxpayers.

The report validates the benefits of extending choice in adult hearing care and supports the aims of NHS England’s Five year Forward View  to meet needs, focus on early intervention and reduce costs by developing new models of care out-of-hospital.

David Hewlett, Chief Executive of NCHA, said: “Once again an authoritative report endorses the need to expand community hearing services. Those who are seeking ways to cut services, relying on outmoded models of care or ducking issues of poor outcomes and unmet need should wake up and listen to the sector regulator. Monitor makes it clear that the NHS can achieve more for patients at lower costs and  this  – not cuts - should now be the priority for 2015-16.  We are calling for a national commissioning framework to guide commissioners and providers and, in the meantime, better contract management to take action against providers that do not deliver for patients.”

The long awaited review, first announced in July 2014, finds  that the community hearing care pathway has added to NHS capacity by providing care out of hospital and closer to people’s homes.

The review also describes how some CCGs have "missed opportunities" to utilise data to monitor and enforce contracts.  “This is more than missed opportunities” said Harjit Sandhu, Head of Policy at the NCHA: “The Health and Social Act 2012 makes clear that ensuring continuous quality improvement is a duty for commissioners, not an option. We welcome Monitor’s report but feel regulators and NHS England should not let CCGs or providers off the hook for failing to commission or deliver follow-up care – a chronic problem for over 30 years. NCHA data showwhat is easily achievable by good commissioning and contract management.  Monitor’s report validates what we have been saying for years now; we can do more for less, hold us to account, but make sure there is a fair playing field. We are delighted that Monitor plans to review services again in 12-18 months. If services have not changed and the Five Year Forward View not realised by then commissioners should be held to account.”

Mark Georgevic, Chair of the NCHA:  “If a lack of knowledge of the community pathway is genuinely holding the service back, as Monitor reports, then the tragedy will be that we have the tools to save the system and support people to age well but lack the willpower to make it a reality. We are willing to work with CCGs to help them develop new and cost-effective ways to collect and share data. We emphatically support patients having better information at referral and are very pleased this has been recommended: this must now be delivered by all CCGs.”

The NCHA has been consistently calling for the NHS to press ahead in developing a national commissioning framework for adult hearing services to bring the gains of community hearing care to NHS patients across the country.

The organisation has long argued for hearing care commissioning to be based on evidence and outcomes data, and will be producing a detailed analysis of Monitor’s report and supporting data in the coming weeks. In particular the NCHA has underlined that the changes necessary to modernise the NHS hearing service cannot be delivered without better information for patients at the point of referral, improved data transparency from all providers, bringing an end to the failure to offer timely follow-up care and mainstreaming an approach that puts patients at the heart of what the NHS does.