Executive summary
This executive summary presents the results of a rapid review of the evidence relating to access to NHS healthcare for deaf people and people with hearing loss.
- We reviewed 3,427 records identified through a primary database search (PubMed and Web of Science) and a grey literature search designed with input from RNID subject experts.
- Of these, we included 30 pieces of published literature and 39 pieces of grey literature in the final review.
Findings
This evidence review clearly demonstrates that the communication and information needs of deaf people and people with hearing loss are not being met, with significant consequences for health and wellbeing.
An information need refers to the format people need information to be given in to understand it.
A communication need refers to the support or adjustments that people need to understand and be understood when communicating with staff.
Examples include having access to a British Sign Language (BSL) interpreter, ensuring staff face people while speaking, and enabling communication in accessible formats, not just over the phone.
We found that these needs often go unmet, for multiple reasons: poor awareness and negative attitudes from healthcare professionals (HCPs), inconsistent access to communication support professionals, and inaccessible use of digital communication tools and technology.
- 70% of people in England had never been asked about their communication needs when accessing NHS care [1]
- 67% of sign language users in England have been denied the information and communication support they need when accessing healthcare [1]
- Only 9% of people were satisfied or very satisfied with provision of BSL interpreters [2]
The consequences are significant, resulting in severe emotional impacts and a loss of privacy and independence, as well as consequences for healthcare such as low health literacy, and people avoiding or delaying care or misunderstanding diagnosis, treatment, and medication information.
- 47% of people in England who had been denied the communication or information support they needed gave up trying to make an appointment [1]
- Only 10.6% of deaf people and people with hearing loss understood all the information they had been given during NHS appointments. 18.3% understood none of the information they were given [2]
- 95% of sign language users find it stressful to access NHS services due to having to fight for their communication needs [1]
Our findings are consistent with the findings of the UK Government’s BSL Advisory Board’s Independent report on BSL user experience of health and social care in the UK.
Together, these demonstrate the persistent systemic challenges facing people who are deaf, deafblind, or have hearing loss using UK health services.
Research gaps
We identified two key research gaps
- Research evaluating the impact of unmet communication needs and inaccessible healthcare on health outcomes
- Research identifying and evaluating effective interventions to improve access to healthcare, such as deaf awareness training for healthcare professionals
Policy context
Healthcare professionals in the UK are required to ensure equitable access to healthcare under the Equality Act 2010 (England, Wales and Scotland) and Disability Discrimination Act 1995 (Northern Ireland).
The Accessible Information Standard (AIS) in England and All Wales Accessible Communication and Information Standards in Wales further require healthcare services to meet the communication and information needs of people with sensory impairments. Scotland and Northern Ireland do not currently have specific guidance in place.
- RNID policy statement: The Accessible Information Standard
- Learn more about challenges specific to each nation
Supplementary material
- Rapid evidence review protocol (.docx)
- Rapid evidence review search strategy (.docx)
- Study characteristics (.docx)
- PRISMA flow reporting review results (.docx)
Sources
[1] RNID and SignHealth. (2025). Still Ignored: The Fight for Accessible Healthcare PDF [Policy Report: England]. RNID.
[2] Parmar B, Henshaw H, Howe S, et al. (2025). ‘I always feel like I’m the first deaf person they have ever met:’ Deaf Awareness, Accessibility and Communication in the United Kingdom’s National Health Service (NHS): How can we do better? PDF PloS One, 20(5), e0322850.