Vicki Kirwin, Development Manager (Audiology & Health)
Recent headlines across the media have suggested that the NHS plan to cut some “ineffective” routine surgeries to save money. One of the treatments supposedly under threat is grommet surgery for children with glue ear.
We are aware that some of our members have raised concerns about the impact of these cuts on deaf children. However, we don’t feel that the headlines are a true reflection of the NHS proposals. We have read the draft consultation proposed by the NHS and it is clear that grommet surgery will still be available to all children who meet the current guidelines. It seems that the proposed changes are a way of making health professionals adhere more closely to these guidelines, rather than an attempt to stop the procedure altogether.
The selection criteria outlined in the proposal are:
- All children must have had specialist audiology and ENT assessment.
- Persistent bilateral otitis media with effusion (glue ear) over a period of 3 months.
- Hearing level in the better ear of 25-30dbHL or worse averaged at 0.5, 1, 2, & 4 kHz
- Exceptionally, healthcare professionals should consider grommets in children with persistent glue ear in both ears with a hearing loss less than 25- 30dbHL, where the impact of the hearing loss on a child’s developmental, social or educational status is judged to be significant.
- The guidance is different for children with Down’s Syndrome and Cleft Palate, these children may be offered grommets after a specialist MDT assessment in line with NICE guidance.
- It is also good practice to ensure glue ear has not resolved once a date of surgery has been agreed, with tympanometry as a minimum.
We feel that these guidelines are appropriate and we are not currently concerned that there will be a negative impact on the selection process. We don’t expect that it will be harder for families to access grommet surgery for their child; if it’s clinically necessary and their choice of intervention. If families have had issues getting the right treatment for their child we do, however, urge them to contact our Helpline.
The NHS consultation will be published soon and we will be responding to the final version. We will also closely monitor how the proposals are implemented locally. If anyone is concerned about the availability of grommet surgery in their local area please contact our Helpline or the Campaigns team at NDCS.Campaigns@ndcs.org.uk.
Elin Wyn, Policy and Campaigns Officer Wales
I had glue ear when I was about three or four years old. I don’t remember much about it, other than being told I had to eat copious amounts of ice cream after an operation to remove my tonsils and adenoids. I never imagined that fifty years later I would experience glue ear again.
It started in January after a particularly stubborn cold that just would not go away. I noticed that I had to turn the volume on the television louder and that I was missing bits of conversation in the office. As the weeks went on my hearing gradually got worse. Meetings at work were increasingly difficult – not only could I not hear everything that was said but because I could hear my own voice very loudly in my head I spoke more quietly than usual. Even when I did try to take part nobody could hear me! My social life almost disappeared. I went to the theatre one evening and despite sitting in the fourth row from the front still couldn’t hear everything. When I met friends in a pub or restaurant it was practically impossible for me to follow conversations in the noisy environment. So the past few months I’ve been staying at home bingeing on television box-sets!
Being so isolated made me think more about the children that I support in my work as a Policy and Campaigns Officer for NDCS Cymru. 80% of children will experience temporary deafness because of glue ear before they are 10 years old. Some children will have recurring episodes that may last for several months or years. Not being able to hear in class or play and talk to your friends can have a devastating impact on a child’s language and social development. Sadly many education and healthcare professionals are not aware of the signs that a child may be experiencing temporary deafness. A child may become withdrawn, might not respond to questions or be isolated in social groups. When I had my glue ear as an adult I was able to understand what was happening and tell people that I’d lost my hearing. A young child might not understand or have the confidence to say that they had problems hearing. That is why it is so important that we ensure that deaf awareness is a high priority for all schools.
As for me, after the GP prescribed several different nasal sprays and drops, four months later my hearing is more or less restored and I have managed to avoid the grommets operation suggested by the ENT consultant. And my neighbours are happier – the television volume is back down to normal!