• Foundation trust claims CCG plan to ration hearing aids would breach legal duties
  • CCG says ‘difficult approach’ is proposed to help save £9.7m
  • Bariatric surgery would also be restricted if plans go ahead 

A foundation trust is warning commissioners they risk breaching their legal duties by rationing hearing aids.

Milton Keynes CCG is considering proposals to restrict hearing aids from two to one as part of a raft of measures to save £9.7m this year.

People with moderate hearing loss would only be eligible for a hearing aid if they are “suffering a significant negative impact” on their lives and those with mild hearing loss would not receive any if the plans go ahead.

However, Central and North West London Foundation Trust says the “incredibly damaging” proposals ignore medical evidence and conflict with NHS England’s current strategy on hearing loss.

The FT also referenced the NHS Constitution and the Health and Social Care Act 2012 in its detailed response to the CCG’s consultation.

It stated: “A decision to proceed with these proposals would run contrary to national policy, robust evidence, professional opinion and would contravene the duties of the CCG.

“We are very surprised that you are considering rationing services given the evidence demonstrating the benefits of hearing aids and impact of unaddressed hearing loss, the national focus on hearing loss and the extensive guidance and support available to improve the value and effectiveness of services without restricting access.

“We call on you to drop these proposals and work to improve the cost-effectiveness and quality of services instead.”

North Staffordshire became the first commissioner in NHS history to restrict access to hearing aids in October 2015 and other CCGs have considered similar plans.

A spokeswoman for Milton Keynes CCG said the board’s final decision on the proposed changes would not be announced until after the election on 8 June.

However, its own final recommendation states the CCG board “should not pursue the original proposal to limit service provision and exclude patients with mild hearing loss, and should not limit the supply of a second hearing aid.”

Asked about the FT’s comments, the CCG spokeswoman said: “We are aware of their response and that has been taken into consideration as part of the CCG’s response to the consultation.”

Although Milton Keynes CCG received a 2.4 per cent increase in its £312m budget for 2017/18, commissioners say funding for 2016/17 was 3.9 per cent below its assessed fair share and it is required to save £9.7m this year.

In its “Clinical Priority and Best Value Consultation”, the CCG proposes an end to routine funding of procedures of limited clinical value including bariatric surgery, female sterilization and hip and shoulder arthroscopies to save £1.8m.

Podiatry, community services and the supply of medicines would also change, with an end to prescriptions for over-the-counter medication expected to save around £66,000 a year. Funding for gluten-free foods on prescription, currently costing £100,000 a year, would also stop.

Outlining its proposals, the CCG said: “Sometimes commissioning healthcare for a whole population means proposing a difficult approach to make best use of resources and enable best care to be available.”

However, the Royal College of Surgeons is also urging the CCG to withdraw its proposal to restrict funding for bariatric surgery after NHS England devolved commissioning responsibility to CCGs from 2016/17.

A RCS spokesman said: “Milton Keynes CCG’s decision ignores evidence-based advice from NICE and NHS England about its benefits and who should be eligible for surgery.

“Denying patients innovative surgery that is safe, effective and economical, which could dramatically improve their overall health and quality of life, is wrong.”