In 2015, Action on Hearing Loss lobbied for the publication of this guideline and acted as a key stakeholder in its initial development. We also responded to NICE’s consultation on the draft version in January. The final version of the guideline titled ‘Hearing Loss: Assessment and Management’ has now been released, and is available to read here.
The NICE guideline has been produced by a committee of experts in hearing loss, and consists of recommendations on how to best identify, refer, diagnose, treat and manage patients based on the best evidence available. The guideline officially only covers England. Decisions on how they apply to Wales, Scotland and Northern Ireland are made by the devolved administrators, who are often involved and consulted with in the development process.
The publication of the NICE guideline reflects the national priority to tackle the growing public health challenge of hearing loss. It is a vitally important document which will further strengthen the case for the prevention and management of hearing loss. And enable providers and commissioners to recognise the impact of hearing loss on individuals, and the economic burden that unaddressed hearing loss places on the health and social care system.
The guideline makes a number of recommendations which run contrary to proposals to restrict hearing aid provision made by several CCGs across the country in recent years. A key recommendation is that the provision of hearing aids should be based on need rather than on hearing thresholds. The guideline states that descriptors such as ‘mild’, ‘moderate’, ‘severe’ or ‘profound’ should not be used as the sole determinant for the provision of hearing support, since this is not a reliable indicator of the difficulty experienced with communication and impact of hearing loss on day to day to life.
The guideline also highlights the cost effectiveness of hearing aids. Stating that fitting hearing aids would be highly cost-effective compared to no treatment at the NICE cost-effectiveness threshold. It also recognises the association between hearing loss and dementia, and recommends referring adults with diagnosed or suspected dementia for hearing assessment.
Health and care professionals are also recommended to provide adults with hearing loss information about assistive listening devices and organisations which can provide advice on how to obtain them. Recommendations are also set out on the removal of ear wax in primary and community care.
When put into practice, NICE guidelines have the potential to effectively target health and care resources to significantly improve patient outcomes, in line with the best evidence available of clinical and cost-effectiveness. The publication of the NICE guideline on hearing loss comes at a critical time when we have seen budget cuts to audiology services and proposals to cut the provision of hearing aids across the country. The challenge which lies ahead now is ensuring that the guideline is implemented by health and social care practitioners and commissioners.
We will be working closely with NICE to promote and support the implementation of the NICE guideline to achieve better outcomes for patients, and reductions in local variation in access and quality of care across the UK.