Now hear this: The case for community based hearing care

It is still early days for the brave new world of the NHS. While the implications of the latest reorganisation and the passing of the Health and Social Care Act are still becoming apparent, what is clear is that a growing number of clinicians and commissioners are embracing the opportunity to redesign, and indeed reimagine, how services are delivered in their areas.

‘Age related hearing loss has a much greater impact on the health of our communities than previously understood’

Even before the passing of the act there was a growing recognition that services needed to be redesigned around patients to drive real change. A patient centred approach has seen specialists leave hospitals and tertiary centres to go into communities to help primary care staff deliver high-quality services where patients can get the most value from them.

Shift in provision

We have seen some excellent work in areas such as diabetes, for example, which has enabled primary care professionals to improve the health of their communities, while freeing up specialists to spend more time with difficult-to-treat people with numerous comorbidities.

‘In age related hearing loss we have a very common long term condition that could cause a range of potentially very costly complications’

There is increasing acceptance that getting to patients earlier and keeping them healthy within their communities is key to the long term future of our NHS.

What has all this got to do with hearing loss? Surely it is a minor problem affecting older people to a nominal degree, and in a completely different way to other long term conditions?

Unfortunately, there is increasing evidence that age-related hearing loss has a much greater impact on the health of our communities than previously understood.

Consider the following

• There is a strong link between unassisted hearing loss and the risk of people developing dementia. Even mild hearing loss increases the risk of developing dementia almost twofold, and severe hearing loss makes a person five times more likely to develop dementia.
• Hearing is associated with older people falling. The risk of someone having a fall in a 12 month period increases by 40 per cent for every 10 decibel worsening of hearing loss they experience.
• Impaired hearing can lead to psychological problems such as anxiety and depression, as well to social isolation, leading to an overall decline in quality of life.
• In the UK, people tend to take between eight and 20 years before they seek medical help after first experiencing hearing loss.
• A recent large study of the UK population found that a quarter of adults aged 40-69 reported problems with their hearing.

When you look, you very quickly start to see a familiar pattern. In age related hearing loss we have a very common long term condition that, if left unaddressed, could cause a range of potentially very costly complications, and which has a clear unmet need in terms of access to care.

Luckily, unlike some other conditions, we have simple solutions available that can have a massive impact on outcomes and streamlining care.

Community based solution

Many people are waking up to the fact that community based solutions are the key to reducing the burden of age-related hearing loss in the UK. October saw the launch of the National Community Hearing Association, an umbrella organisation that will provide a voice for UK hearing care providers and drive the agenda of “better hearing for all” within government.

Behind the launch of the organisation is a broader movement to see hearing services become a common sight within our communities, similar to the status of dentists’ surgeries and opticians today.

‘Hearing services are a great example of how simple, community based services can provide a real benefit for patients’

The passing of the Health and Social Care Act and the introduction of any qualified provider has provided a unique opportunity to realise this vision. Already, 44 per cent of clinical commissioning groups are commissioning community based hearing services to move care towards a patient-centred service.

This is encouraging but, given the unmet need, we really need to be doing more to deliver better care in our communities. Better access equals better experiences and outcomes for patients. There really is no reason why 100 per cent of CCGs should not be commissioning community based hearing services.

It seems clear that hearing services are a great example of how simple, community based services can provide a real benefit for patients while freeing up specialists’ time for people who really need it.

We believe hearing care will soon establish itself as the fifth primary care service in the UK, delivering quality care within communities and providing huge health benefits to a large number of people. We might even start to wonder what took us so long.

Colin Campbell is director of professional services for Specsavers Hearing Centres