A flagship partnership between government and a leading charity has failed to make digital hearing aids readily available on the NHS. Six years after the Royal National Institute for Deaf People (RNID), the Department of Health (DH) and the NHS's purchasing and supplies agency joined forces to take hearing aids into the digital age, patients are still having to wait up to five years for a hearing aid.
The £125m, three-year scheme to modernise audiology services throughout England, complete with state-of-the-art digital hearing aids, was held up as one of the first examples of a charity successfully co-managing a DH project.
By March 2005, RNID teams had trained audiology departments across the country to fit and programme 300,000 new devices, while the charity's then chief executive, James Strachan, had led negotiations to reduce their cost to the NHS. By harnessing the NHS's enormous purchasing power - with 500,000 aids bought each year - the price for each aid fell from £2,000 to £155 in the first round of contracts and to £75 in the second. "We acted as a catalyst for NHS purchasing and supply to think differently," says Angela King, RNID senior audiologist.
More than a million people have now received digital hearing aids on the NHS, but a further half a million people in England are still waiting to be switched over from the analogue variety, which often whistle and amplify background noise.
The reason for the backlog, says the RNID, is government failure to address audiology departments' lack of capacity during the modernisation process. "We hoped that by upgrading the technology it would act as a lever to raise the profile of audiology and make it something the NHS locally wanted to invest in," King says.
In addition to existing hearing aid wearers, a further 250,000 people each year visit their doctor for the first time with a hearing problem, with 95% needing a hearing aid.
In 2000, when the partnership began, the average waiting time for a new hearing aid was five to six months. It now stands at 40 weeks, while reassessments are taking an average 64 weeks. The longest delay, revealed in a survey released last week by the Conservative MP, Grant Shapps, was in hospitals in Blackpool, Fylde and Wyre Trust, which take 260 weeks - five years - to replace old-fashioned aids.
The government says it is aware of the problem and plans to launch an action plan next month that will help clear the log jam. However, Tim Loughton, Conservative MP and vice-chair of the all-parliamentary group on deafness, says that if government is serious about tackling long delays it must include hearing aids in its 18-week waiting list targets. Although targets to see a consultant within 13 weeks will be introduced by March, and within six weeks by December 2008, Loughton says these targets only apply for first referral.
"It is meaningless to have a waiting list target for the first referral because you could still be waiting years to have the hearing aid fitted," he says. Without a waiting list target for the entire procedure - known as the "patient journey" from seeing a GP, to having a hearing test, and finally a hearing aid fitted - Loughton fears that primary care trusts (PCTs) will have no incentive to purchase provision from the independent sector. "It will not be a priority," he says.
Money aside
A pilot private-public partnership run by the RNID as part of its modernisation programme bears out Loughton's concerns. Money was put aside for PCTs to purchase 50,000 patient journeys from two private hearing aid companies. When the money ended after 18 months, so did the PCTs' willingness to continue using the private sector to boost capacity. "We need more partnerships like this," says Loughton, whose own constituents in East Worthing and Shoreham, West Sussex, are waiting up to two years for NHS hearing aids.
John Low, chief executive of the RNID, says: "PCTs must be encouraged to invest in hearing aid services to reduce unacceptable waiting times. It makes no sense to make people wait so long for an inexpensive but vital piece of equipment that can make such a difference to their everyday lives and reconnect them to society."
The Commons health select committee is due to examine the issue in March.
· Any comments on this article? Write to society@theguardian.com
