NICE Update: Hearing loss assessment proposals

The NHS England Action plan on hearing loss identifies the need for improved early identification of hearing loss and early treatment.

Hearing loss affects over nine million adults in England. A Hearing matters paper from charity Action on Hearing Loss estimates that 5.6 million adults in England would benefit from having a hearing aid. Of these, an estimated three million adults in England already have one.

Some of the recommendations are likely to have a resource impact. This is particularly the case for recommendations affecting people with hearing difficulties presenting to healthcare professionals for the first time, who would not currently be referred to audiology services, and people in the general population who have hearing loss but have not previously been referred.

Where hearing difficulties are not caused by impacted wax and acute infections, patients should have an audiological assessment and be referred for additional diagnostic assessment if needed.

About 491,000 people are involved in such cases in England each year, and around 73% of them currently go on to have an assessment. Hearing aids will be recommended for just over half of the people having an assessment, and it is estimated that 85% of people will have a hearing aid for both ears. It is anticipated that the guideline will be implemented at a linear rate over the next five years, with an annual cost from year five onwards of £20.7m in England.

The resource impact for people with hearing loss but who have not previously been referred for a hearing assessment is less certain. A resource impact report and template considers this. It is estimated that for every 10% uptake in the prevalent population, there would be a cost in England of around £10m across the implementation period.

Prices for hearing assessment and hearing aid provision are agreed at a local level and commissioners are advised to use the template to calculate local impact.

Services for people with hearing loss are commissioned by clinical commissioning groups. Providers are NHS hospital trusts, community providers and primary care.