Quality statement 5: Provision of hearing aids

Quality statement

Adults presenting with hearing loss affecting their ability to communicate and hear are offered hearing aids.

Rationale

The primary management option for permanent hearing loss is hearing aids. Hearing aids can reduce the impact of hearing loss, improving communication and participation in everyday life. People should be offered the number of hearing aids that they need. In most cases hearing loss affects both ears. If a person has hearing impairment in both ears, there is significant benefit to wearing two hearing aids rather than one. Binaural amplification gives better sound quality and improved intelligibility of speech in background noise.

Quality measures

Structure

Evidence of local arrangements to ensure that adults with hearing loss affecting their ability to communicate and hear are offered hearing aids.

Data source: Local data collection, for example, key performance indicators from local contracts that include service specifications.

Process

a) Proportion of adults presenting with hearing loss affecting their ability to communicate and hear who have aidable hearing loss in one ear who are given one hearing aid.

Numerator – the number in the denominator who are given one hearing aid.

Denominator – the number of adults presenting with hearing loss affecting their ability to communicate and hear who have aidable hearing loss in one ear.

Data source: Local data collection, for example, audit of electronic case records.

b) Proportion of adults presenting with hearing loss affecting their ability to communicate and hear who have aidable hearing loss in both ears who are given two hearing aids.

Numerator – the number in the denominator who are given two hearing aids.

Denominator – the number of adults presenting with hearing loss affecting their ability to communicate and hear who have aidable hearing loss in both ears.

Data source: Local data collection, for example, audit of electronic case records.

Outcome

Hearing-specific health-related quality of life for adults with hearing loss.

Data source: Local data collection, for example, a patient survey. NHS England's Adult hearing service specifications (2016) include outcome 2 on improvement in service-user-reported quality of life using validated self-reporting tools such as the Glasgow Hearing Aid Benefit Profile (GHABP) or the Client-Orientated Scale of Improvement (COSI).

What the quality statement means for different audiences

Service providers (audiology services) ensure that processes are in place for adults with hearing loss affecting their ability to communicate and hear to be offered hearing aids. They ensure that healthcare professionals are aware that they should offer one or two hearing aids depending on whether the person has aidable hearing loss in one or both ears.

Healthcare professionals (audiologists) discuss and agree hearing aid options with the adult based on their communication and hearing needs, and as part of an individual management plan. They offer one or two hearing aids depending on whether the person has aidable hearing loss in one or both ears.

Commissioners (such as clinical commissioning groups) ensure that services they commission have the capacity and expertise to give hearing aids to adults with aidable hearing loss. They monitor whether services restrict hearing aids by not offering them to people with aidable hearing loss in one ear or both ears, or by only offering one hearing aid to adults with aidable hearing loss in both ears.

Adults with hearing loss that affects their ability to communicate, and that can be improved by a hearing aid, are offered a hearing aid, or two hearing aids if they have hearing loss in both ears.

Source guidance

Hearing loss in adults: assessment and management (2018) NICE guideline NG98, recommendations 1.6.1 and 1.6.2

Equality and diversity considerations

Healthcare professionals should adapt their communication style to the hearing needs of the person with hearing loss. This will help to ensure that the person has the opportunity to be involved in decisions about their hearing management options, which should be documented in their personalised care plan.

For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible information standard.