The FACTS are out there. The difficulty is in knowing where to find them and to understand when they have passed their expiry date. Here are some sources.
Quoting the Freedom of Information Act 2006 and referencing procurement 2018/S 140-319871,
[email protected] are obliged to provide answers to questions such as:
1. When was a Nuheara product awarded a contract under Lot1 (£34.5m), Lot6 (£4m) or any other Lot in this procurement?
2. Can a product that is not conformity assessed and CE-marked as a medical device be accepted into Lot5?
3. Can a Universal Fit ITE device (i.e. an ITE device that does not have a Custom Fit ear insert) be accepted into Lot5?
4. Can the Lot5 specification be changed during the contract period, to allow for the subsequent creation of a new ‘Hearable’ sub-category that is not a medical device and is an ITE that is not custom fit?
What I learned from asking the NHS similarly, back in January, was that the award on 27th November 2018 was provisional and subject to a 10-day standstill period for receiving objections and to verify claims. No actual contracts were entered into at all in November 2018. The NHS told they withdrew the provisional award for the Nuheara product before it could be converted into a contract item. 2 months on, I advise that you ask them directly, to verify if there has been any change since.
FOI also tells how much the NHS pays for hearing aids on contract (up to April 2018 anyway), such as: https://apps.nhsbsa.nhs.uk/FOI/foiRequestDetail.do?bo_id=7587 . The total value column in the downloadable csv contains 20% tax and 3% procurement fee. The individual hearing aid price = total value / eaches / 1.23. Mild to moderate hearing aid prices range from £30 to £60, with an average around £50. The big 5 can make a satisfactory margin at this price point (I used to work for one)
With regards to the channels fitting NHS hearing aids under the AQP scheme, such as many Specsavers franchises, the contract prices vary slightly between the CCGs. The national tariff (indicative, non-mandatory) is currently £268 for fulfilling a referral for a single hearing aid and £370 for a binaural pair. The AQP is typically reimbursed about £65 for replacing a broken hearing aid, which include the cost of the hearing aid itself and seeing the patient. AQP is high volume, low margin business, which favours hearing aid models that are lowest cost and demand the least aftercare (i.e. reliable and simple, not giving reason for the patient to come back). Link to an example case: https://www.hammersmithfulhamccg.nhs.uk/media/137532/GB-11-Sept-Item-10-AQP-audiology-full-business-case-v6-GB-110918.pdf .
Switch to NON-FACT reading more.
My belief is that the concept behind the Boost has a lot of merit. Self-care must be the way forward in hearing health, as the rationale behind the US OTC regulation evidences. The rest of the World and the NHS will follow suit, eventually.
The NHS's institutionally conservative and risk adverse clinical protocols are unfortunately slow evolving. Its clinicians are powerful and they resistingly fear deregulation (their profession depends on it). My personal guess is that the average clinician will think the Boost is a step too far, too fast. They will primarily focus on its shortcomings (and I personally think it has a few) rather than buying into its merits. In my view the Boost is not ready for the NHS and the NHS is not ready for the Boost, never mind what is right for the patient. As a purely personal view, Nuheara products will not make it on to the new 4-year contract. They might sell a handful of units p.a. off-contract, to curious NHS clinicians. I believe those adventurous clinicians will find it far too expensive to prescribe.
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