1.Name of CCG:
2. Are any of the adult hearing services provided though Any Qualified Provider (AQP) in your CCG area?
3. Do you have a policy on the implementation of the NICE guideline ‘Hearing loss in adults: assessment and management’ when providing adult audiology services?
4. Do you hold information on the following for your CCG area:
5. a) How many hearing aid fittings took place in the services you commission in each of the following years for adults.
b: how many hearing aid fittings took place in each of the following years for children:
c: how many hearing aid fittings took place in total (adults + children):
6. Do you have a hearing loss threshold dBHL, below which adults will not be prescribed hearing aids?
7. When adults have an aidable hearing loss in both ears, what is your CCG policy? (Please select the relevant response)
8. Do you commission any hearing screening programme in your CCG area?
9. For the services you commission please tell us how many Whole Time Equivalent (WTE) audiologists provide (or provided) services to adults? Please include all audiologists, including locums.
10. What is your tariff (or cost) for the following for non-complex adults (please complete table):
11. Do the services you commission offer a one stop assess and fit service for people with hearing loss? This is a service where hearing aid assessment and fitting takes place on the same day.
12. Is any of the following data collected in relation to outcomes from adults using hearing loss services in your area? (Please select all that apply)
13. Do you publish any of this data?
14. Do you use outcomes data as part of your commissioning and monitoring arrangements?
15. Are adult hearing loss services in your CCG area commissioned on the basis of activity (e.g. number of procedures performed) or on the basis of outcome (e.g. patient outcome data)? Please select the relevant option and provide further details:
16. What follow-up arrangements are offered to patients who have received a hearing aid fitting from the services you commission?
17. If services automatically offer follow-up appointments, do you have any policies or targets in place for the length of time between hearing aid fittings, and follow up appointments?
18. Do you hold any data on the actual length of time between hearing aid fitting and first follow up appointment?
19. How do the services you commission offer follow-up appointments to patients? (Please tick all that apply)
20. Do the services you commission provide audiology clinics out of hours i.e. after 6pm/ before 9am/ at weekends?
21. We would like to know more about the services you commission and any charges patients may experience.
21a. If the services you commission do not provide this service, please specify how people obtain their hearing aid batteries:
22. If you have any comments on the above, or if there are any other charges related to hearing aids or audiology service provision in your CCG area, please specify here
23. For patients fitted with hearing aids, in what ways do the services you commission offer re-assessments of their hearing needs after a period of time (please indicate all that apply)
24. If services offer an automatic re-assessment, after how many months/years does this take place for non-complex patients/
25. If services offer re-assessment on patient request or GP referral, is there a minimum number of months/years they have to wait before requesting this?