Sunday 13 November 2016

Questions put to Wyre Forest CCG Governing Body

Questions put to Wyre Forest Clinical Commissioning Group at Board Meetings in Public

Question for WFCCG 2nd DEC 2014
asked by Kathleen Hill at Board Meeting in Public.

Awareness that CCG have to be very careful with money.

Involved with national charity fighting a CCG over Proposed Withdrawal of a service from a huge swathe of patients on eligibility criteria based on figures and tables rather than individual patients' needs.  Evidence from actual patients on how they benefit from current treatment is being ignored. Thousands of patients are likely to be adversely affected.

Need assurance from our CCG that patients' individual clinical requirements will always be a major factor in determining their subsequent referral and treatment, and that referral will  not depend solely on a predetermined set of criteria set by people who have no experience of patients' problems.

Question for WFCCG Board Meeting in Public 31 03 2015

A lot of very encouraging information about services and equality.  Pleased to see that Mental health and well-being services are being addressed.  Is addressing hearing loss included in those services? According to Action on Hearing Loss the largest charity in the country addressing hearing loss there is clinical evidence to show that unaddressed hearing loss leads to isolation, depression and dementia.  1 in 6 of the population has some degree of hearing loss.  There is also evidence to show that hearing loss should be addressed sooner rather than later before it has become severe.  Sadly, many CCGs in England are not recognising this and are reducing services for the HoH.  

Is the addressing of hearing loss included in mental health and well-being services?
Are there any plans for routine screening of the over 60s who are at increasing risk of developing age related hearing loss which, if unaddressed, can have a serious impact on their ability to communicate?

Answer
Very encouraging response from the board.  Hearing aid provision has increased since Specsavers became an AQP as people are going for sight tests and having hearing tests as well.  
No plans to reduce services.

Update: November 2016  The provision of hearing aids to those with ‘mild’ hearing loss is now on a shortlist of 6 services under review with the very real possibility of cuts to services.

Update: November 22nd 2016 The threat to hearing aid provision has been put on hold for the time being as the CCGs have realised they will save very little money. However, I was told on 24th November that should further cuts in finance be imposed then the situation will need to be reviewed again.


Q for WFCCG Governing Board Meeting in Public
Tuesday 5th April 2016 submitted by Kathleen Hill

Help shape the future of healthcare  services
Survey

I am concerned that brief explanations of medical conditions and their impact does not go far enough to enable a considered response.  
  • Eg. £1 million spent on hearing aids implies this could be saved.  How much of that is actually spent on hearing aids for people with mild hearing loss?  
  • Similarly in other categories the total figure spent on procedures is given when surely only part of that is likely to be saved in most of them - eg: hip and knee replacements.

In addition I am concerned about the formula that may be used to determine hearing loss level.
  • I have evidence of one used elsewhere where some higher frequencies are not tested and the lower ones - those that most people with age related high frequency loss can hear well - are included in an average score thus suggesting a better ability to make sense of speech than is actually experienced by the patient.  

Current advice is that people should seek help with hearing loss sooner rather than later before the difference between noise levels heard with and without hearing aids becomes too great for patients to cope with.  
  • Department of Health & NHS England Action Plan on Hearing Loss (23rd March 2015) states that Objective 2 (Page 20) is to “ensure that all people with hearing loss are diagnosed early …… and that they are managed effectively once diagnosed.”  
  • Page 22 “Hearing is a major factor in maintaining independence and achieving healthy ageing.”
  • Link between hearing loss and dementia is also mentioned.  There is a  recognised pathway - hearing loss - isolation - depression - dementia.


Can Worcestershire patients be confident that audiology specialists and not other clinicians, or admin staff, with little or no audiological specialist knowledge will be able to determine - in conjunction with their patients - who will benefit from and be provided with hearing aids?


Issue raised at WFCCG Board Meeting in Public 07.06.2016
by
Kathleen Hill (GP Surgery PPG rep and Volunteer Speaker for Action on Hearing Loss)

Reference: Document 10b. Operational Plan 2016/2017 Page 50 Putting Patients at the Centre

“Ensure that patient experience data is utilised and that patients are directly engaged with when redesigning and re commissioning services.”


I wish to emphasise what I have already said in the past that all patients should be treated as individuals and assessed on the impact that their condition has on their lives when decisions are made on whether or not to treat them.  My own area of patient expertise is hearing loss and, with respect, it is abundantly clear to me that the board does not understand this condition.  It is complex and definitions such as ‘mild’ are nebulous and meaningless so far as possible impact on a person’s life is concerned.  This highlights how difficult it is for those who have no experience of medical. conditions to understand them and it therefore follows that it is questionable whether or not they are the people who should be making decisions about who should be treated.  I have filled in and submitted a copy of the   Help shape the future of healthcare services in Worcestershire survey and submitted a covering letter.  

I would like assurance from the board that these and all patient submissions will be studied in detail and not merely filed away in order to tick a patient consultation box.

Forwarded by email so that CCG has a copy for reference.



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