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Commissioning framework for adult hearing services

The Commissioning Framework for adult hearing services, which we helped NHS England to develop, provides a clear guide to what good commissioning looks like for hearing loss services. Find out what this means for you.

Hearing is central to our health and wellbeing. Approximately one in six people has hearing loss, which impacts on employment, mental health, independence and quality of life. And it will become an even bigger challenge due to the growing ageing population and increased exposure to workplace and social noise.

While there has been substantial progress in improving hearing services over the last 10 years, significant challenges remain. These were addressed in the government’s Action Plan on Hearing Loss. Download the Action Plan.

The commissioning Framework for adult hearing services, published in 2016, was developed as part of NHS England’s commitment to implement the Action Plan on Hearing Loss. It aims to support local commissioners to deliver improved hearing loss services to benefit the increasing numbers of people who need to use them.

Supporting Clinical Commissioning Groups

The Commissioning Framework sets out why it’s important to address hearing loss, evidence of the impacts of hearing loss and the cost effectiveness of hearing aids, and what patients want from hearing services. It explains how to commission high-quality hearing services that:

  • are evidence-based
  • take into account local needs
  • are easy to access
  • meet people’s communication needs
  • monitor outcomes for patients
  • are cost-effective.

The Framework also contains information and tools such as:

  • local prevalence data for each area of the country
  • a model service specification
  • a set of outcomes measures and performance indicators
  • detailed case studies of innovative delivery models that have streamlined the audiology pathway, integrated hearing services with other NHS and social services, or seen better outcomes from providing all or part of the service in the community.

Clinical Commissioning Groups (CCGs) should use the Framework as a basis for discussions and agreements with providers on how to increase the quality and cost-effectiveness of services. The Framework also encourages CCGs to ensure that GPs in their area have an awareness of the needs of people with hearing loss and the audiology pathway, and good training in the impacts and management of hearing loss.

Please email Policy.Practice@beta.rnid.org.uk if you have any questions about the Framework or would like support implementing its recommendations.

Supporting providers of hearing services

The Framework outlines the importance of high-quality hearing services and sets out examples of innovative audiology pathways that improve access, quality, cost effectiveness, integration and/or engagement with local populations.

Hearing services providers can use the Framework to show how important hearing services are and the priority placed on them by NHS England. The outcomes measures, planning tools, evidence and examples can be used to help plan how to meet local needs, monitor and improve quality, and demonstrate the positive impacts of the hearing service to the Trust and CCG.

Supporting GPs

The Framework makes clear the importance of identifying and addressing hearing loss as soon as possible in order for people to gain the maximum benefits from hearing aids, and so that unaddressed hearing loss doesn’t pose risks to their independence and mental and physical health.

Many people who could benefit from free NHS hearing aids don’t have them. The GP is crucial in identifying hearing loss in their patients and encouraging them to get a prompt referral to hearing services for a hearing assessment.

The Framework suggests GPs should check people’s hearing regularly as they get older – we recommend every three years. GPs should ensure they are aware of the impacts of hearing loss, the hearing services in their area, whether patients have a choice, and any other local services that can provide support or equipment for people with hearing loss.

See more guidance for GPs here

Page last updated: 27 October 2020

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