This guideline covers some aspects of assessing and managing hearing loss in primary, community and secondary care. It aims to improve the quality of life for adults with hearing loss by advising healthcare staff on assessing hearing difficulties, managing earwax and referring people for audiological or specialist assessment and management.
The guideline covers adults aged over 18, including adults whose age of onset of hearing loss was under 18 but who present for the first time in adulthood.
In October 2023, we updated the recommendation on considering suspected cancer pathway referral for adults of Chinese or south-east Asian family origin with hearing loss and a middle ear effusion not associated with an upper respiratory tract infection in line with NHS England’s standard on faster diagnosis of cancer. People should have a diagnosis or ruling out of cancer within 28 days of referral.
This guideline includes recommendations on:
- assessment and referral
- removing earwax
- investigation using MRI
- treating idiopathic sudden sensorineural hearing loss
- assessment and management in audiology services
- hearing aids and assistive listening devices, including follow-up in audiology services
- information and support
Who is it for?
- Health and social care professionals
- Commissioners of health and social care services
- People with hearing loss, their families and carers
Guideline development process
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.