Hearing loss is a major public health issue affecting about 9 million people in England. Because age-related hearing loss is the most common type of hearing loss, it is estimated that by 2035 there will be around 13 million people with hearing loss in England – a fifth of the population. The psychological, financial and health burden of hearing loss can be reduced by prompt and accurate referral, robust assessment and correct management.

The care offered to people with hearing difficulties varies from place to place, and many people face delays in having their hearing loss identified and managed. Most hearing difficulties are age related and need assessment and management by the local audiology team. Earwax may complicate the clinical picture and cause hearing difficulties, and can be treated in primary or community care. Other causes of hearing difficulties need prompt, or even urgent, investigation and treatment by specialist services.

This guideline aims to improve the quality of life for adults with hearing loss by providing advice for healthcare staff on who to refer for audiological assessment, how to manage earwax in primary and community care and when to refer people for specialist assessment and management. The guideline also offers advice on assessment and follow‑up in audiology services, and information and support for people with hearing loss. In addition, the guideline considers best practice in the management of idiopathic sudden sensorineural hearing loss and MRI as an investigation for hearing loss.

It is important that the person with hearing loss has the opportunity to participate in making decisions about management, in partnership with their healthcare professionals, and this is reflected in the guideline.

  • National Institute for Health and Care Excellence (NICE)