Quality statement 6: Follow-up audiology appointment

Quality statement

Adults with hearing aids have a follow-up audiology appointment 6 to 12 weeks after the hearing aids are fitted.

Rationale

A follow-up audiology appointment is important for assessing how someone is adapting to their hearing aids and whether they fit well. It also provides an opportunity to resolve difficulties at an early stage, review the personalised care plan and give additional advice based on progress. Face-to-face appointments should be offered first, with the option to attend this appointment by telephone or electronic communication if the person prefers. Face-to-face appointments are preferred so that the audiologist can check the fitting and handling of the hearing aids and make any necessary adjustments. Without this service, people may stop using their hearing aids, which can reduce their quality of life as their ability to communicate and participate in everyday situations decreases.

Quality measures

Structure

a) Evidence of local arrangements to ensure that adults with hearing aids have a follow-up audiology appointment 6 to 12 weeks after the hearing aids are fitted.

Data source: Local data collection, for example, service specifications.

b) Evidence of local arrangements to ensure that adults with hearing aids have their personalised care plan reviewed and updated if necessary during a follow-up appointment 6 to 12 weeks after the hearing aids are fitted.

Data source: Local data collection, for example, service specifications.

Process

a) Proportion of adults who have a follow‑up audiology appointment 6 to 12 weeks after new hearing aids are fitted.

Numerator – the number in the denominator who have a follow‑up audiology appointment 6 to 12 weeks after the hearing aids are fitted.

Denominator – the number of adults with new hearing aids.

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

b) Proportion of adults who have a face-to-face follow‑up audiology appointment 6 to 12 weeks after new hearing aids are fitted.

Numerator – the number in the denominator who have a face-to-face follow‑up audiology appointment 6 to 12 weeks after the hearing aids are fitted.

Denominator – the number of adults with new hearing aids.

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

c) Proportion of adults who have a telephone follow‑up audiology appointment 6 to 12 weeks after new hearing aids are fitted.

Numerator – the number in the denominator who have a telephone follow‑up audiology appointment 6 to 12 weeks after the hearing aids are fitted.

Denominator – the number of adults with new hearing aids.

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

d) Proportion of adults who have a follow‑up audiology appointment by electronic communication 6 to 12 weeks after new hearing aids are fitted.

Numerator – the number in the denominator who have a follow‑up audiology appointment by electronic communication 6 to 12 weeks after the hearing aids are fitted.

Denominator – the number of adults with new hearing aids.

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

Outcomes

a) Proportion of adults continuing to wear new hearing aids after first follow-up, and at 12 and 24 months.

Numerator – the number in the denominator continuing to wear new hearing aids after first follow-up, and at 12 and 24 months.

Denominator – the number of adults with new hearing aids.

Data source: Local data collection, for example, data logging and self-reporting. NHS England's Adult hearing service specifications (2016) include a key performance indicator on the proportion of patients continuing to wear hearing aids after first follow-up, and at 12 and 24 months.

b) Hearing-specific health-related quality of life for adults with aidable 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 pathways, protocols and processes are in place for adults with hearing aids to have a follow‑up audiology appointment 6 to 12 weeks after the hearing aids are fitted. Services are configured to offer the person an appointment face-to-face as the first option, or the option of follow-up by telephone or electronic communication if preferred.

Healthcare professionals (audiologists) work in partnership with adults with hearing aids (and their family or carers if appropriate) at the face-to-face, telephone or electronic communication follow-up audiology appointment to assess how the person is adapting to their hearing aids and resolve any difficulties at an early stage. They provide further advice and support, and onward referral if needed. They review and update the personalised care plan, ensuring that any unmet needs or goals are addressed, and provide the person with a copy.

Commissioners (clinical commissioning groups) ensure they commission services with the capacity and expertise to provide a follow‑up audiology appointment that is either face-to-face as the first option, or by telephone or electronic communication, if preferred, 6 to 12 weeks for adults after their hearing aids are fitted.

Adults who have hearing aids fitted are offered a follow‑up appointment with the audiology service 6 to 12 weeks after their hearing aids are fitted. They can go to the appointment in person, or have it by telephone or electronic communication such as email or messaging. At the appointment their hearing aids will be checked and their personalised care plan updated. The healthcare professional will ask about any problems with the hearing aids and give advice and support, if needed, to help the person use them.

Source guidance

Hearing loss in adults: assessment and management (2018) NICE guideline NG98, recommendation 1.7.1

Definition of terms used in this quality statement

Audiology appointment

At the follow‑up audiology appointment for adults with hearing aids:

  • Ask the person if they have any concerns or questions.

  • Address any difficulties they have with inserting, removing or maintaining their hearing aids.

  • Provide information on communication, social care or rehabilitation support services if needed.

  • Tell the person how to contact audiology services in the future for aftercare, including repairs and adjustments to accommodate changes in their hearing.

  • Ensure that the person's hearing aids and other devices meet their needs by checking:

    • the comfort, sound quality and volume of hearing aids, including microphone and noise reduction settings, and fine-tuning them if needed

    • hearing aid cleaning, battery life and use with a telephone

    • use of assistive listening devices

    • hours the hearing aid has been used, if shown by automatic data logging.

  • Review the goals identified in the personalised care plan and agree how to address any that have not been met (for information on the personalised care plan, see recommendation 1.5.2).

  • Update the personalised care plan and provide them with a copy.

[NICE's guideline on hearing loss in adults, recommendation 1.7.2]

Equality and diversity considerations

Healthcare professionals should adapt their communication style at the follow-up appointment to the hearing needs of the person with hearing loss. They should ensure that communication is effective enough to discuss any concerns or questions the person has about their hearing aids, resolve difficulties at an early stage and review the goals identified in the 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.