We are putting forward the case for a UK National Eye Health and Hearing Study (UKNEHS) - a collaborative nationwide project developed by Anglia Ruskin University in cooperation with the College of Optometrists, Vision UK, the Thomas Pocklington Trust, Royal College of Ophthalmologists and a number of other partner organisations across the eye health and hearing sector.
We need a UKNEHS to address the desperate need for high quality, up-to-date data on hearing loss and eye health, so that the UK can evaluate our current services, plan future services in the most effective way, improve outcomes for those affected, and develop a more effective public health strategy in these crucial areas.
The UKNEHS is a nation-wide study encompassing all four nations. It will focus on four key objectives; Effectiveness, Efficiency, Economy and Compliance. The study team aims to keep digital transformation opportunities at the heart of the study. The UKNEHS will identify the prevalence and causes of hearing and vision impairment and blindness in the UK population aged 50 and over, providing an up-to-date and comprehensive picture of the UK’s eye and hearing health. The results of this work will feed into a wider programme of activities, which will enable us to understand where our current services can be improved, and how we can more effectively and efficiently use resources to reduce preventable sight and hearing loss, and correct impairments to vision and hearing in the UK population.
The case for investment describes the causes of vision and hearing impairment, providing an overview of both the international and national policy landscape for eye and hearing health, and how eye and hearing health services are currently commissioned and delivered. It outlines the need for change in these sectors, and the key drivers for this. It describes the solution (the UKNEHS), the benefits it will bring, and the investment required. Finally, we outline how the UKNEHS can be successfully delivered; including the governance and resources needed and finally, it outlines how we will measure benefits and ensure objectives are met.
The case for change
Visual impairment (including sight loss and blindness) costs the UK an estimated £28 billion per annum, and hearing impairment £30 billion each year.
Despite these huge costs, we don't have the data we need to understand why people are still losing their sight and hearing due to preventable or treatable causes, or living with correctable vision and hearing impairments under our current system.
Widely used datasets in the UK are of limited value, due to a reliance on non-UK international data, or UK data samples that are either very small scale, or not generalisable to the population as a whole. There is subsequently no robust evidence-base upon which to found research, or to target the right preventions, treatment, public health services and support to people who really need it. Demand for eye and hearing health services is growing every year, and there is a real need to have accurate data to establish an up-to-date, reliable baseline for the UK’s eye and hearing health, to inform future evaluation of services and research.
The data we have indicates that there is unmet need in the system, with barriers to accessibility, lack of awareness of the health benefits of regular sight tests and delays to treatment caused by the current health system, meaning that needs are not being met and people are losing their sight and hearing and living with correctable visual and hearing impairments where these outcomes could have been avoided.
The load on services is projected to increase in the future due to an ageing population with increasingly complex needs. Growth in conditions such as diabetes is resulting in additional pressures on other parts of the system. With demand growing and resources under increasing pressure, it is more important than ever to understand the health needs of our population so that we can target interventions effectively and provide quality care.
All of this is crucial because sensory loss has a huge impact on people’s overall health and wellbeing, and as a result, a major economic impact on wider society through its effect on employment, education and training, social inclusion, wellbeing and access to services.
Without the UKNEHS data it is impossible to develop evidence-based plans for how to improve services and deliver them more efficiently and effectively to reduce the numbers of people losing sight and hearing, or living with vision and hearing impairments that could be corrected. Better data is essential if the NHS’s Long Term Plan is to be delivered successfully in the eye health and hearing sectors.
The solution
A UKNEHS will provide vital data for the vision and eye health research community in the UK, for health policy makers and those developing and commissioning health services. It will allow for more effective implementation of the most appropriate health services and delivery models and provide a critical data baseline to support future impact assessment of novel eye care interventions and service delivery models. This will help government efficiently and effectively ensure that vulnerable groups are accessing the services they need to reduce preventable hearing and vision loss.
Each participant enrolled in the UKNEHS will undergo an eye and hearing examination, and complete a standardised general questionnaire. Interviews and examinations will be conducted primarily at designated clinics. Where that is not possible they will be delivered in the participant’s home.
The study will also measure the detection and treatment coverage rate of major eye diseases and conditions in order to understand the effectiveness of current services. People surveyed will be asked questions to help us understand their level of interaction with eye health services and the effectiveness of them, as well as to understand the impact of eye health on employment levels (where applicable).
If a participant has a problem identified during the survey, they will be referred for treatment via the appropriate local pathway. It is estimated that approximately 1,500 participants will be found to have an undetected eye condition as part of this process.
Benefits and delivery of a successful UKNEHS
The study will deliver immediate benefit to the 1,500 individuals with previously undetected vision problems, ensuring they receive the interventions needed to treat or manage their condition. It will also offer improved outcomes for people over the long term, by gathering data on prevalence to establish a greater understanding on the causes and incidence of eye disease and hearing loss. It will support a better understanding of regional and socio-economic variances in vision and hearing status and outcomes – enabling us to ensure that those groups in society who are least well served by current services, and most at risk, are better understood.
The economic benefit of dealing with preventable and treatable hearing and vision loss is significant. Currently, ophthalmology is the second largest department in the NHS. A full economic costing has costed the study at £16 million over 3 years. This figure is 0.52% of the overall £3.1 billion spent by the NHS on eyecare and hearing loss in the UK annually, in other words a relatively small investment in order to target overall spend.
The UKNEHS project will be led by a team of highly experienced health research professionals, and is supported by a number of partner organisations across the eye health and hearing sectors. The project will draw on other similar studies already delivered successfully in Australia, Trinidad and Tobago, Nepal and Bangladesh. This document describes the study proposal, which will be developed in full as part of detailed design phase of work, working closely with Government funding partners.
UKNEHS Case for Investment FULL document.