"Hearing loss in both ears"

About: Royal Hallamshire Hospital / Ear, Nose and Throat

(as the patient),

To my great surprise when I picked my hearing aids up. I was told that I could only have one because of financial cutbacks. I could not believe that I could be denied a hearing aid on cost grounds.

I have two ears therefore I need two hearing aids! I enclose this article about the need for two hearing aids.

I have done some research on the advantages of wearing two hearing aids.

If you’re like most people with hearing loss, it’s probably taken some time to accept that you need a hearing aid at all, let alone two.

If you have hearing loss in only one ear and normal, or nearly normal, hearing in the other, then one hearing aid is all you need. But most people have hearing loss in both ears, especially age-related hearing loss. In that case, research and experience suggest that you’ll be more satisfied with two hearing aids.

When you have two hearing aids, you can take better advantage of the way the brain processes sound through what’s known as “binaural” hearing. With normal hearing, most sounds that we hear enter both of our ears. (There are exceptions: If you rub two fingers together just outside your right ear, virtually all of the sound from your fingers is being processed just by that ear. )

When a sound enters both of our ears, each ear sends its version of that sound to the brain. The brain interprets the sound by processing the signals from both ears, and it does a better job of processing the sound when it’s getting signals from both. For example, the brain can pick out important signals, like voices, and interpret what those voices are saying even when there’s a lot of background noise.

If you’re wearing just one hearing aid, even though you have hearing loss in both ears, your brain may have a harder time distinguishing voices from other sounds in a noisy place. It may also be harder for the brain to identify the location of particular sounds. The brain normally does this by comparing the relative loudness and frequencies of the sound signals that are coming into both your ears, as well as how long it takes them to travel through the ears. But the brain can’t locate a sound as well if sound signals are always louder through one ear.

Another advantage of wearing two hearing aids is that you can set each of them at a lower volume than if you wear just one. And lower volume means less feedback and distortion of the sounds around you.

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Responses

Response from Sarah Neil, Quality Manager for Patient Experience, NHS Sheffield CCG (Lead commissioner)

Thank you for taking the time to post your story and tell us about your concerns about the provision of hearing aids.

NHS Sheffield Clinical Commissioning Group has been looking at research studies around the effectiveness and benefits of one versus two hearing aids, and we are currently reviewing our policy to ensure that it is based on the best available evidence.

We will post a fuller response when we have finished reviewing our policy, but in the meantime if you want to discuss your specific case please feel free to call me on 0114 3051094.

Kind regards,

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Update posted by jsknight100 (the patient)

Thank you for your response. Do you know when you will have finished your review into the benefits of having two hearing aids?

I find hearing difficult when I with a group of people & I am talking to the person on my right as my hearing aid is in my left ear. I go to the gym three times a week to do pilates or yoga. I find I have to try & copy the person next to me as I cannot hear the instructor. The problem is worse when lying on the floor.

Response from Sarah Neil, Quality Manager for Patient Experience, NHS Sheffield CCG (Lead commissioner)

Dear jsknight100,

It is hard to give an exact timeframe because to help us we are obtaining information from another organisation, and so it depends on how long this takes, but we expect to complete the review within the next six – eight weeks.

Thank you for the extra information that you have provided in relation to your experience of having one hearing aid - I have passed this on to the staff conducting the review.

Kind regards

Sarah

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Update posted by jsknight100 (the patient)

There is a maxim "Justice delayed is justice delayed" I feel this applies to my case.

I appealed against having only one hearing aid on the 7th May nearly 3 months ago. I seem to be no nearer to receiving a reply. I feel that the NHS grinds people down by having a slow bureaucratic response hoping that people will give up & go away!

Most NHS commissioning groups give people two hearing aids if they need them. Why doesn't Sheffield?

Response from Deborah Hopkinson, Patient Experience Co-ordinator, Sheffield Teaching Hospitals NHS Foundation Trust

Thank you for your comments which you have posted on Patient Opinion. We have noted that the Sheffield Clinical Commissioning Group have responded to you and would advise that our Trust have been requested by them to continue with the current pathway but working alongside them to review the pathway for patients who have dual hearing difficulties.

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Update posted by jsknight100 (the patient)

Could you please let me know when I will get a response to my request for two hearing aids? I don't think that it is an unreasonable request as most commissioning groups provide two hearing aids.

I enclose some information supplied by Action on Hearing Loss formally RNID.

We recently surveyed all 129 NHS trusts that provide adult audiology across England, and received 116 responses. Of these only one – Sheffield – has this policy to not provide two hearing aids to anyone unless they go through an ‘individual funding request’. Two other services offer two hearing aids only if the person requests two, and one other service is contracted to only provide two hearing aids to 25% of patients. This is extremely rare – all the other 112 trusts across England provide two hearing aids where clinically appropriate.

Contrary to what Sheffield CCG say, there is extensive evidence of the benefits of fitting two hearing aids, rather than one, for people with hearing loss in both ears. Research shows that bilateral fittings:

• help people identify which direction sound is coming from (Stephens et al, 1991; Dreschler and Boymans, 1994)

• suppress tinnitus (Brooks and Bulmer, 1981)

• reduce the risk of auditory deprivation (where a lack of stimulation in the cochlea affects the brain’s ability to interpret speech sounds) (Silman et al, 1984; Silman et al, 1992; Hurley, 1993)

• improve speech clarity and reduce listening strain (Köbler and Rosenhall, 2002; Leeuw and Dreschler, 1991), which can subsequently improve people’s ability to participate in social situations, and their emotional wellbeing (Noble and Gatehouse, 2006; Brooks and Bulmer, 1981).

More information and references can be found in our underpressure report here and more in our policy statement.

I enclose a link to their web site: http://www.actiononhearingloss.org.uk/

Response from Sarah Neil, Quality Manager for Patient Experience, NHS Sheffield CCG (Lead commissioner)

Dear jsknight100,

The review is underway with a number of clinicians involved. We are still working to the timetable mentioned previously (six – eight weeks) and we expect to have reached a decision within the next one - two weeks. We will post further information when the review is concluded.

Sarah

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Update posted by jsknight100 (the patient)

It is now 27th August, nearly four months since I requested a second hearing aid. I have still not heard anything about whether the NHS is going to give me a second hearing aid. It seems that Sheffield is the only NHS trust that does not give two hearing aids as a matter of course.

It does make me think that if there was a national policy on what medicines to provide it would save a lot of time and money on bureaucracy and more could be spent on patient care. Could you please let me know when I am likely to receive a decision? The last reply to me was posted on Patient Opinion over three weeks ago. You stated that ""and we expect to have reached a decision within the next one - two weeks. "

Update posted by jsknight100 (the patient)

I heard on Monday 1st September that my request for a second hearing aid had been granted but nothing has happened yet. It is nearly two weeks since I heard by email that I would be getting a second hearing aid. The letter has not arrived yet.

Today I asked for the Chief Audiologists email address and they were reluctant to give the address. I feel that the NHS tries to grind one down. One has to fight for everything.

Response from Sarah Neil, Quality Manager for Patient Experience, NHS Sheffield CCG (Lead commissioner)

Hello - I am sorry that you have not received the letter yet. I have emailed you directly and confirmed that we will send you another copy of the letter. Kind regards, Sarah

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Response from Sarah Neil, Quality Manager for Patient Experience, NHS Sheffield CCG (Lead commissioner) We have made a change

We have completed our review and can confirm that we are making a change to ensure that patients who, after a period of trialling one, find that one hearing aid is not sufficient and have a clinical need for two hearing aids will be able to have a second hearing aid.

I am sorry that you have not received your letter yet – we will send you another copy.

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