Monday 5 December 2016

Hearing Aids Under Threat 4 Worcestershire CCGs - Future of Healthcare Services



Here is the link to WFCCG Website section concerning public consultation on the future of services and updates on actions taken as a result.

http://www.wyreforestccg.nhs.uk/getting-involved/your-say-on-the-future-of-healthcare-services/

Below are the press releases from Action on Hearing Loss as a result of the statement made by Worcestershire CCGs on 22nd November.

Posted on 23/11/2016

Action on Hearing Loss welcomes the decision not to cut hearing aids in Worcestershire

Action on Hearing Loss has welcomed the decision made by the NHS Redditch and Bromsgrove Clinical Commissioning Group (CCG), NHS Wyre Forest CCG and NHS South Worcestershire CCG not to restrict access to hearing aids for local people across Worcestershire.

The decision means that hearing aids, the only viable treatment for hearing loss and one that is extremely cost effective, will continue remain freely available for people with a hearing loss in the area.

The three Clinical Commissioning Groups announced their decision (22 November) following a survey in 2016, with Action on Hearing Loss providing robust clinical evidence highlighting the flaws in the proposed restrictions and demonstrating the lifeline that hearing aids represent to people with hearing loss. The charity’s view was supported by hearing aid providers, the audiology community, local deaf groups and thousands of local people.
Paul Breckell, Action on Hearing Loss Chief Executive, said: ‘We are delighted with the decision made by the NHS Redditch and Bromsgrove Clinical Commissioning Group (CCG), NHS Wyre Forest CCG and NHS South Worcestershire CCG not to restrict hearing aid services in Worcestershire which have always been available for free to local people in Worcestershire from the NHS.
‘We appreciate that they accepted our robust clinical evidence and took into consideration the feedback that they received from patients, community groups and other key stakeholders as part of the engagement exercise, with the three CCGs concluding that significant savings could not be achieved through the cutting of hearing aid services – indeed, it is crystal clear that any policy of this nature is a false economy given the costs it will incur in the longer term.
‘We look forward to engaging and working with the three Worcestershire CCGs in the future to offer our support and expertise to help ensure local people have access to high quality hearing aid services in line with NHS England’s National Commissioning Framework for Audiology Services which was published in July 2016.’

Statement from NHS Redditch and Bromsgrove Clinical Commissioning Group (CCG), NHS Wyre Forest CCG and NHS South Worcestershire CCG

Update (22 November 2016)
Over the past few months the Worcestershire CCGs have undertaken more work on the areas identified above. This has allowed the CCGs to develop a more clear understanding of the likely impact of implementing any proposed changes. The CCGs are currently unconvinced about the level of savings that would be achieved were specific restrictions to be introduced to primary care hearing aid services and ‘over the counter’ medicines on prescription.
Taking this into consideration, along with the responses received from patients, community groups and other key stakeholders as part of the first phase of engagement, the CCGs are not taking proposals around primary care hearing aid services or ‘over the counter’ medicines any further at this stage.
Contact for media enquiries:
Gorki Duhra, Senior PR Officer at Action on Hearing Loss, telephone: 020 7296 8057 / 07944 038635 or email gorki.duhra@hearingloss.org.uk , @HearingLossPR

Sunday 13 November 2016

Reading an Audiogram - The Speech Banana



Reading an Audiogram


I used this document to illustrate how hearing loss affects the clarity of speech.  I sent it to Dr Shapley together with the letter I wrote to him.    The original document can be found here: 


Please do not use the altered version below in any other publication.



The Importance of Hearing Aids - Getting the Message Across to CCGs

The Importance of Hearing Aids

Getting the Message Across to Clinical Commissioning Groups

***** On 15th February 2017 Action on Hearing Loss asked me to answer some questions about my experiences of hearing loss on BBC Radio 4’s Woman’s Hour.  Following this I was asked if I would allow Action on Hearing Loss to quote from this blog post in a presentation designed to help people understand hearing loss.  I am really pleased that I seem to be on the right track. *****

The following article was originally written for - and published on - Action on Hearing Loss’s website. https://www.actiononhearingloss.org.uk/community/blogs/our-guest-blog/the-importance-of-hearing-aids.aspx The letters and sounds that someone with ‘mild’ high frequency hearing loss (most often associated with age/noise related hearing loss) might struggle to hear have been removed in an attempt to offer some insight into the difficulties those with impaired hearing might face.  It should be remembered that whilst readers can read and work out meaning at their own individual pace people do not enjoy that luxury in real time verbal conversations.  Lipreading is not a substitute for hearing. Much of it is guesswork - filling in the gaps left by sounds made without moving the lips.  Add the distraction of background noise to the mix and for many the struggle becomes too great.  Isolation, depression and dementia (perceived or real) are very significant threats.

Please read on.  At the end there are a few questions you may like to ponder and answer.

I am a -earing aid wearer wi-- mild to modera-e, -igh -re-uen-y -earing lo--.  I -ave worn digi-al N-- -earing aid- -or --e la-- -our-een year-.  -o -ay --a- --ey -ave -ran--ormed my li-e i- no e-aggera---n.  

Loo-ing ba-- over my -re--earing aid year- I wonder -ow I managed.  A- a middle ---ool -ea--er in charge of the -E de-ar-men- but -ea--ing -al- my -ime-able in -la--room -ubje--- I --ru--led -on--an-ly.  -earing what --ildren were -aying in the gym or on --e -ield wa- a -er-e-ual -roblem and I wa- re-ea-edly -om-laining about --ildren mumbling and --ea-ing indi--in---y in the -la--room.  --a-- mee-ing- were a nigh-mare.  My brain -ad to wor- over-ime to -ry to -ee- tra-- of di--u----ns --at I wa- too o-ten relu--an- -o join in a- I -ould not be -ure wha- -ad been -aid.  Al--ough I did not reali-e i- at --e -ime i- -a- be-ome a--aren- --a- --e --eer e--or- of ma-ing -en-e of -onver-a---n --roughou- --e day wa- what -au-ed me to -lum- into a -oma-li-e -lee- every evening - --u- robbing me of -rue re-- and rela-a-ion a--ivi-ie-.  On o--a-ion- when I --ar-ed wa---ing a -elevi---n -ro-ramme I o-ten had to a-- family member- what had been -aid only to be -old --at I --ould -ay -ull a--en--on.  I rarely -aw --e end- of -ro-ramme-.

I- i- only in re-irement -in-e re-eiving my -ir-- N-- -earing aid- --at I -ully a--re-iate ju-- -ow -ard --e --ru--le wa- during my wor-ing year-.  No lon-er do I need --e -ub-i-le- when wa---ing -elevi---n.  Now I -an enjoy -onver-a---n- wi-- -amily member-, -riend- and a--uain-an-e- wi--out re-ea-edly -aving to a-- for re-e-i---n and -u--ering --e en-uing embarra--men- of --ill no- -aving -eard -ro-erly.  --ere are only -o many -ime- one -an a-- for re-e-i---n and --ere i- alway- --e added worry of ini-ia-ing t-e o-ten u--ered di-mi--ive re--on-e, "Oh! It doe-n'- ma--er." Only re-i-ien-- of --o-e -ew word- will -ruly under--and --e -ru--ra---n --ey -au-e.  --e -on--ant worry about being -il-ered out of --e -rou- whil-- al-o dealing wi-- --e --rain of -rying to --ay -onne--ed i- now -one.  

The --rain on -amily member- and other- --ould not be undere--imated.  A -riend -old me --a- -eo-le wi-- -earing lo-- --ould do -ome--ing abou- i- a- i- wa- e--remely -ru--ra-ing -o have -o re-ea- --ing- -o much.  I wa- an-ry wi-- her a- --e -ime but on re-le---on --e did me a -avour.  -onver-a---n i- de-igned to -low and re-ea-ed re-e-i---n --oil- --e -low.  I- i- diffi-ult to move on when -on--antly moving ba--.  -on-inui-y is di-ru--ed and bo-- --e -earing and the -earing im-aired be-ome -ru--ra-ed.  --i- i- e--a-erba-ed on --e -ele--one - a -om-le-e nigh-mare -or --e -ard of -earing and --o-e -rying to -ommuni-a-e wi-- --em.

Re-irement o--ers relea-e from a li-e-ime of -lo-ely --ru--ured a--ivi-ie- but al-o -re-en-- challenge- o- i-- own. -ow will we ju-ti-y our -ontinued e-i-ten-e in --e world?  I de-ided to be-ome involved in lo-al -a---n--' -om-i--ee-.  Why -u- my-elf --rough --e a-ony o- ye- more mee-ing-?  I am a -ommuni-a-or and I wan-ed -o -on-inue to -on-ribu-e to -o-ie-y.  De--i-e -ur--er de-eriora---n in my -earing my N-- -earing aid- allow me to do ju-- --a-.  Deva--a-ed i- a mu-- overu-ed word --e-e day- but i- -ully de--ribe- -ow I would -eel wi--ou- my -earing aid-.  -o---l out-a-- would not be too --ro-- a de--rip---n.  (I a--ually --ough- one o- my -even -rand--ildren had a -eriou- --ee-- im-edimen- a- I -ould not under--and any--ing he -aid.  --i- -ear -roved un-ounded on-e I re-eived my -earing aid-.)   

A- a wal-er and a -y-li-t I rely on my -earing aid- to help aler- me to -o-en---l -azard-
a--o-ia-ed wi-- tho-e a--ivi-ie-.  In addi---n devi-e- -u-- a- doorbell-, -imer- and alarm- would be inaudible wi--ou- --em.

I -eel driven to -ee- u- --e-igh- again-- any -o-en---l -u-- in N-- -earing -ervice-.  I, and -o many like me, would become -eriou-ly -o--ally i-ola-ed and vulnerable wi-- all --e o--er -roblem-
a--o-ia-ed wi-- bei-- ex-luded from normal everyday a--ivi-ie- --at --o-e wi--ou- -earing -roblem- -a-e -or -ran-ed.

  1. How far did you get?   
    1. If you gave up part way through could you explain why?
  2. How do you feel?
  3. Were you able to read at your normal pace?
  4. Would you like all your reading matter to be like this?
  5. If the answers to 3 and 4 were, “No,” would you welcome help to overcome these problems?
    1. For your convenience the full text of this article with all the gaps filled in is printed below or can be seen here: https://www.actiononhearingloss.org.uk/community/blogs/our-guest-blog/the-importance-of-hearing-aids.aspx
    2. During conversation people with hearing loss rely on their hearing aids to help fill in the gaps.
    3. Without hearing aids whilst the brain struggles to decipher words orally the conversation may be moving on resulting in further gaps in comprehension.  Eventually the effort becomes too great and many are reduced to smiling and nodding - or, worse, total withdrawal.  Isolation.

Hearing loss is a complex issue.  It is not just about turning up the volume. People who seek help  need help.  Please let patients and audiologists decide who will benefit from hearing aids.
Kathleen Hill
Member of:
GP PPG, Wyre Forest Patients’ Group,
NHS Wyre Forest CCG Membership Scheme
Action on Hearing Loss https://www.actiononhearingloss.org.uk/ (Formerly the RNID) Volunteer

Updated 13th January 2020

The Importance of Hearing Aids
Original Action on Hearing Loss Blog Article Posted on: Monday, February 2, 2015 by Lola Olson

I am a hearing aid wearer with mild to moderate, high frequency hearing loss.  I have worn digital NHS hearing aids for the last eight years.  To say that they have transformed my life is no exaggeration.  

Looking back over my pre-hearing aid years I wonder how I managed.  As a middle school teacher in charge of the PE department but teaching half my timetable in classroom subjects I struggled constantly.  Hearing what children were saying in the gym or on the field was a perpetual problem and I was repeatedly complaining about children mumbling and speaking indistinctly in the classroom.  Staff meetings were a nightmare.  My brain had to work overtime to try to keep track of discussions that I was too often reluctant to join in as I could not be sure what had been said.  Although I did not realise it at the time it has become apparent that the sheer effort of making sense of conversation throughout the day was what caused me to slump into a coma-like sleep every evening - thus robbing me of true rest and relaxation activities.  On occasions when I started watching a television programme I often had to ask family members what had been said only to be told that I should pay full attention.  I rarely saw the end of programmes.

It is only in retirement since receiving my first NHS hearing aids that I fully appreciate just how hard the struggle was during my working years.  No longer do I need the subtitles when watching television.  Now I can enjoy conversations with family members, friends and acquaintances without repeatedly having to ask for repetition and suffering the ensuing embarrassment of still not having heard properly.  There are only so many times one can ask for repetition and there is always the added worry of instigating the often uttered dismissive response, "Oh! It doesn't matter."  Only recipients of those few words will truly understand the frustration they cause.  The constant worry about being filtered out of the group whilst also dealing with the strain of trying to stay connected is now gone.  

The strain on family members and others should not be underestimated.  A friend told me that people with hearing loss should do something about it as it was extremely frustrating to have to repeat things so much.  I was angry with her at the time but on reflection she did me a favour.  Conversation is designed to flow and repeated repetition spoils the flow.  It is difficult to move on when constantly moving back.  Continuity is disrupted and both the hearing and the hearing impaired become frustrated.  This is exacerbated on the telephone - a complete nightmare for the hard of hearing and those trying to communicate with them.

Retirement offers release from a lifetime of closely structured activities but also presents challenges of its own. How will we justify our continued existence in the world?  I decided to become involved in local patients' committees.  Why put myself through the agony of yet more meetings?  I am a communicator and I wanted to continue to contribute to society.  Despite further deterioration in my hearing my NHS hearing aids allow me to do just that.  Devastated is a much overused word these days but it fully describes how I would feel without my hearing aids.  Social outcast would not be too strong a description.  (I actually thought one of my seven grandchildren had a serious speech impediment as I could not understand anything he said.  This fear proved unfounded once I received my hearing aids.)    
As a walker and a cyclist I rely on my hearing aids to help alert me to potential hazards associated with those activities.  In addition devices such as doorbells, timers and alarms would be inaudible without them.

I feel driven to keep up the fight against any potential cuts in NHS hearing services.  I, and so many like me, would become seriously socially isolated and vulnerable with all the other problems associated with being excluded from normal everyday activities that those without hearing problems take for granted.
Kathleen Hill
Member of GP PPG, Wyre Forest Patients’ Group,
NHS Wyre Forest CCG Membership Scheme
Action on Hearing Loss https://www.actiononhearingloss.org.uk/ (Formerly the RNID) Volunteer

The above articles and other items concerning hearing loss can be found here:  
Kathleen can be followed on:
Twitter @kathleenlhill

Minor updates 19.06.2017

Please help someone else understand hearing loss by passing this on when you have finished with it.

The Importance of Hearing Aids - Original Action on Hearing Loss Blog Post

The Importance of Hearing Aids

Why hearing aids are important to me explained in a post I wrote for Action on Hearing Loss:

Original Action on Hearing Loss Blog Article Posted on: Monday, February 2, 2015 by Lola Olson

I am a hearing aid wearer with mild to moderate, high frequency hearing loss.  I have worn digital NHS hearing aids for the last eight years.  To say that they have transformed my life is no exaggeration.  

Looking back over my pre-hearing aid years I wonder how I managed.  As a middle school teacher in charge of the PE department but teaching half my timetable in classroom subjects I struggled constantly.  Hearing what children were saying in the gym or on the field was a perpetual problem and I was repeatedly complaining about children mumbling and speaking indistinctly in the classroom.  Staff meetings were a nightmare.  My brain had to work overtime to try to keep track of discussions that I was too often reluctant to join in as I could not be sure what had been said.  Although I did not realise it at the time it has become apparent that the sheer effort of making sense of conversation throughout the day was what caused me to slump into a coma-like sleep every evening - thus robbing me of true rest and relaxation activities.  On occasions when I started watching a television programme I often had to ask family members what had been said only to be told that I should pay full attention.  I rarely saw the end of programmes.

It is only in retirement since receiving my first NHS hearing aids that I fully appreciate just how hard the struggle was during my working years.  No longer do I need the subtitles when watching television.  Now I can enjoy conversations with family members, friends and acquaintances without repeatedly having to ask for repetition and suffering the ensuing embarrassment of still not having heard properly.  There are only so many times one can ask for repetition and there is always the added worry of instigating the often uttered dismissive response, "Oh! It doesn't matter."  Only recipients of those few words will truly understand the frustration they cause.  The constant worry about being filtered out of the group whilst also dealing with the strain of trying to stay connected is now gone.  

The strain on family members and others should not be underestimated.  A friend told me that people with hearing loss should do something about it as it was extremely frustrating to have to repeat things so much.  I was angry with her at the time but on reflection she did me a favour.  Conversation is designed to flow and repeated repetition spoils the flow.  It is difficult to move on when constantly moving back.  Continuity is disrupted and both the hearing and the hearing impaired become frustrated.  This is exacerbated on the telephone - a complete nightmare for the hard of hearing and those trying to communicate with them.

Retirement offers release from a lifetime of closely structured activities but also presents challenges of its own. How will we justify our continued existence in the world?  I decided to become involved in local patients' committees.  Why put myself through the agony of yet more meetings?  I am a communicator and I wanted to continue to contribute to society.  Despite further deterioration in my hearing my NHS hearing aids allow me to do just that.  Devastated is a much overused word these days but it fully describes how I would feel without my hearing aids.  Social outcast would not be too strong a description.  (I actually thought one of my seven grandchildren had a serious speech impediment as I could not understand anything he said.  This fear proved unfounded once I received my hearing aids.)

As a walker and a cyclist I rely on my hearing aids to help alert me to potential hazards associated with those activities.  In addition devices such as doorbells, timers and alarms would be inaudible without them.

I feel driven to keep up the fight against any potential cuts in NHS hearing services.  I, and so many like me, would become seriously socially isolated and vulnerable with all the other problems associated with being excluded from normal everyday activities that those without hearing problems take for granted.

Kathleen Hill
Member of GP PPG, Wyre Forest Patients’ Group,
NHS Wyre Forest CCG Membership Scheme
Action on Hearing Loss (Formerly the RNID) Volunteer

Questions put to Healthwatch Worcestershire

Healthwatch Worcestershire Meeting
H&W Draft Proposals for Discussion 11th November 2016
Wyre Forest House Finepoint

  • Page 2 People taking responsibility for own health
    • To be encouraged but no guarantees.
      • Own experience this year of waiting 19 weeks for a physiotherapy appointment - after phoning to find out where my letter was - twice.
      • Treatment should not be denied when it is needed.
  • There are areas where people cannot control their health.
    • Cutting or restricting vital services to patients is deplorable.  Department of Health and NHS England guidelines appear to be being ignored.
    • My own area of patient expertise is hearing loss probably caused by living in London during World War II

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.

See here


for complete document:

Why is the withdrawal of hearing aid provision for people with ‘mild’ hearing loss even on the shortlist of possible cuts to services?

Kathleen Hill
Member of GP PPG, Wyre Forest Patients’ Group,
NHS Wyre Forest CCG Membership Scheme
Action on Hearing Loss Member and Volunteer

Hearing Aids Under Threat 3 Letter to WFCCG 20th May 2016

20th May 2016
Freepost Plus RTCU-KZKZ-EJZZ
NHS S Worcestershire CCG
The Coach House
John Comyn Drive,
WORCESTER
WR3 7NS

Dear CCG Board Members,

Help shape the future of healthcare services in Worcestershire

Open letter to whom it may concern
With reference to the above survey I wish to make the following points:

  • Brief explanations of medical conditions and their likely impact - although laudable - do not go far enough to elicit properly considered responses.
    • People often do not appreciate the true impact that medical conditions have on others.
  • Figures quoted for services appear to be the total amount of money spent on those services.  
    • The implication is that those are the amounts that could be saved when clearly they are not if only parts of the services in question were cut.
  • With particular reference to question 3 - which asks whether or not people with mild hearing loss should be denied hearing aid provision - I wish to make the board aware of the following points:
    • Mild hearing loss in itself is a fairly meaningless diagnosis.
      • It depends upon which frequencies are affected.
      • Age related hearing loss tends to affect the higher frequencies.
        • Consonants are voiced at higher frequencies than vowels.  
        • It is consonants that give speech its meaning.
    • The impact of hearing loss is very individual.
      • I have it on good authority from a senior audiologist that two patients could be assessed as having the same hearing loss but that the impact of that hearing loss on those two individuals could be wildly different.
        • This means that measuring thresholds at which people can hear certain frequencies is not enough to determine whether or not someone could benefit from hearing aids.
      • People can experience more/less success when listening to different people.
        • This is NOT ‘selective’ hearing in the way that is often joked about.
        • It IS ‘selective’ in that different people speak at different frequencies and therefore are more/less understandable depending on the frequencies with which patients have a problem.
        • Eg, People with high frequency loss can often determine men’s  speech better than women’s because men tend to have lower pitched voices than women. There are always exceptions to this, however.
    • The exhausting nature of hearing loss should not be underestimated.  
      • It is extremely tiring for the brain to have to fill in the gaps left by hearing loss.  
        • Imagine many of the consonants missing from a conversation.  
      • It can lead to people distancing themselves - or being distanced by others - from conversations, becoming isolated, depressed and even leading to accelerated development of dementia.
        • Many people with good hearing become frustrated if asked to repeat things for people who have not heard/understood the first, second and possible subsequent times.
        • Do not assume that those who nod and smile have understood what you have said.  It is highly likely they may be too embarrassed to ask for further repetition.
    • 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 states, “Hearing is a major factor in maintaining independence and achieving healthy ageing.”
        • The link between hearing loss and dementia is also mentioned.  There is a  recognised pathway - hearing loss - isolation - depression - dementia.
    • It takes - on average - 10 years for people to address their hearing loss.  When they finally admit that they need help it is because they NEED help.
      • No one wants to wear hearing aids.
        • There is still a certain stigma attached to wearing hearing aids that has to be overcome by the patient.
        • Those who benefit from and persevere with hearing aids do so because their lives are more tolerable with than without.

I understand that the government is cutting your budget and that savings have to be made. However, please consider the perceived savings you may make - in denying hearing aids to those patients for whom some arbitrary scoring system has determined a level of hearing loss  - and compare it with the likely expense of dealing with possible health, quality of life and independence problems that could ensue if patients continue along the pathway -  hearing loss, isolation, depression and accelerated development of dementia.

I suffer from hearing loss and whilst there are certain strategies that can be employed to help with speech understanding the overwhelmingly successful one is my NHS pair of hearing aids.  I also have a badly arthritic knee which gave me pain 24/7 until I tweaked my lifestyle.  As a result of eating more of the right things, fewer of the wrong things, using a pedometer and reducing my weight to within half a stone of the minimum recommended for my height my knee is now largely pain free - most of the time.  My lifestyle helps me to ‘manage’ other musculoskeletal problems, too.  Sadly, this lifestyle tweak effected no improvement in my hearing. Hearing aids are my lifeline, socially and in my voluntary work.  They will be a lifeline to others, too.

Please allow audiologists - together with their patients - to decide who will benefit from and be fitted with hearing aids.  Similarly, patients suffering from other medical conditions should be assessed on an individual basis rather than as members of a nebulous, predetermined group.

Yours sincerely,






Kathleen Hill