BONE ANCHORED HEARING AID (BAHA) POLICY

Transcription

1 BONE ANCHORED HEARING AID (BAHA) POLICY Please note that all Central Lancashire Clinical Commissioning policies are currently under review and elements within the individual policies may have been replaced by the pan Lancashire Clinical Commissioning Policies listed on the webpage. Please ensure that relevant pan Lancashire Clinical Commissioning Policies are read in conjunction with this Central Lancashire Clinical Commissioning Policy. REFERENCE NUMBER DCCE 18 APPROVING COMMITTEE(S) AND DATE Governance Committee AUTHOR(S) / FURTHER INFORMATION Specialist Registrar & Associate Director in Public Health LEAD DIRECTOR Director of Commissioning and Community Engagement THIS DOCUMENT REPLACES New Policy REVIEW DUE DATE May 2011 RATIFICATION DATE/DRAFT No May 2009 VALIDATION SIGNATURE

2 The NHS Central Lancashire is committed to ensuring that, as far as it is reasonably practicable, the way we provide services to the public and the way we treat our staff reflects their individual needs and does not discriminate against individuals or groups on the basis of their ethnic origin, physical or mental abilities, gender, age, religious beliefs or sexual orientation. Should a member of staff or any other person require access to this policy in another language or format (such as Braille or large print) they can do so by contacting the communications department or the relevant policy holder. NHS Central Lancashire will do its utmost to support and develop equitable access to all policies. Managers are responsible for ensuring staff within their area of responsibility are aware of NHS Central Lancashire policies and that staff adhere to them. Managers are responsible for ensuring that a system is in place for their area of responsibility that keeps staff up to date with new policy changes. Staff are responsible for ensuring they are familiar with policies, know where to locate the documents on NHS Central Lancashire website, and seek out every opportunity to keep up to date with NHS Central Lancashire policies. Independent contractors are expected to identify a lead person to be responsible for ensuring staff employed within their practice are aware of NHS Central Lancashire policies. This policy is individual to NHS Central Lancashire. NHS Central Lancashire does not accept any liability to any third party that adopts or amends this policy. NHS Central Lancashire Page 2 of 6

3 CONTENTS 1 INTRODUCTION Scope Principles Exceptionality 4 PAGE 2 BONE ANCHORED HEARING AID POLICY 2.1 Context Inclusion criteria Exclusion criteria 5 3 IMPLEMENTATION REFERENCE DOCUMENTS 6 5 GLOSSARY 6 Page 3 of 6

4 1. INTRODUCTION This is the policy of NHS Central Lancashire to commission Bone Anchored Hearing Aids (BAHA). A BAHA is a surgical treatment for hearing loss that works through direct bone conduction. The device consists of a titanium implant in the mastoid bone, an abutment and an external sound processor; sound is therefore able to bypass the external and middle ear. This policy is written in recognition of service agreements that exist for the provision of BAHA and describes eligibility criteria for these procedures. Patients may satisfy the criteria, or may be confirmed as exceptions by NHS Central Lancashire on an individual patient basis. 1.1 Scope This policy applies to the commissioning of services for those individuals who request BAHA. Exceptional circumstances are considered when funding requests are received. This policy applies to patients who are registered with a Central Lancashire General Practitioner. 1.2 Principles The principles that underpin this policy include the need for NHS Central Lancashire to commission interventions that are evidencebased, based on need and equitably accessible. The principles are outlined in more detail in a separate policy entitled: The Ethical Framework Policy for commissioning individual patient funding requests. 1.3 Exceptionality The Panel will consider the exceptionality of the case when considering funding requests. For the purposes of the policy, exceptionality is taken to mean that the patient is different in their needs compared to other patients with a similar condition requiring an intervention. Page 4 of 6

5 2. BAHA POLICY 2.1 Context A BAHA can be used in the treatment of patients with bilateral or single-sided conductive or mixed (conductive and sensorineural) hearing loss and who cannot benefit from standard air conduction hearing aids due to: Anatomical abnormalities of the outer, middle or external ear Chronic ear inflammation or infection Hearing loss due to acoustic neuroma Implantation of BAHA is considered safe and effective with no serious adverse outcomes. 2.2 Inclusion criteria Implantation of a BAHA will only be considered if the following criteria are met: Conductive or mixed hearing loss and unable to benefit from standard hearing aids. Average bone conduction thresholds at 0.5-4kHz of <40dBHL for an ear level aid and <60dBHL for a body worn aid. Speech discrimination score >60% Patient has realistic expectations about the outcome following BAHA implantation The patient has sufficient social support to look after the BAHA; particularly keeping the area around the fixture clean. 2.3 Exclusion criteria At present there is insufficient evidence to support the implantation of bilateral BAHAs or the use of BAHAs for unilateral sensorineural hearing loss. 3. IMPLEMENTATION Line managers will ensure all staff involved in processing commissioning requests in Public Health, Health Standards and Commissioning Directorates follow the policy. This policy will be available to all General Practitioners and service providers. Page 5 of 6

6 The policy will be available to the public from the NHS Central Lancashire website. Any breaches to this policy will be monitored through the Commissioning Appeals Process and reported to the Governance Committee. 4. REFERENCE DOCUMENTS Guidelines: British Society of Audiology, 2003; BS EN iso and , Consensus statements on the BAHA system: where do we stand at present? Snik AF, Mylanus EA, Proops DW et al. Ann Otol Rhinol Laryngol Suppl Dec;195: GLOSSARY Not required Page 6 of 6