Evidence review: Access to healthcare for deaf people and people with hearing loss using NHS services in the UK

Conclusions and future research

This review has found a clear consensus across the included studies that the communication needs of deaf people and people with hearing loss are frequently unmet by healthcare professionals in the UK.

This unmet need stems from a lack of awareness of, and negative attitudes toward different communication needs, failure to implement systems to meet those needs, and inconsistent access to communication support professionals. It is therefore clear that guidance such as that given by the Accessible Information Standard in England, and the All Wales Standards in Wales, is not being consistently applied.

The impact of unmet needs is significant.

These include emotional impacts, such as increased anxiety about accessing healthcare, and a loss of privacy and independence when unable to independently communicate with health services and professionals.

As a result of negative experiences, deaf people and people with hearing loss may have a lower level of health literacy than their hearing counterparts, avoid seeking help, miss appointments, or lack understanding about their diagnosis, treatment plan, and safe medication use.

However, there are gaps in the evidence.

Firstly, there is a need for research exploring the long-term impact of unmet communication needs on health.

The research reviewed here offers suggestions for how health outcomes might be affected, through avoidance of care or misunderstanding medical information. However, we identified no studies investigating the relationship between access to healthcare and overall health over time. For example, whether a lack of access to interpreters during hospital stays impacts post-surgery outcomes.

Secondly, there is a lack of evidence regarding effective interventions to improve access to healthcare.

A common theme in the included studies was the need for more, or improved, deaf awareness training, designed with input from, and led by, deaf people.

NHS staff identified a lack of training as a key barrier to feeling confident meeting the needs of patients who are deaf or have hearing loss (RNID and SignHealth 2025).

Four of the included studies did provide insights into the impact of deaf awareness training programmes for community nurses in Scotland (Smith et al. 2018), pharmacists in Scotland (Alhusein et al. 2019), and medical or nursing students (Gilmore et al. 2019, Terry et al. 2025).

In all cases, course participants showed improved deaf awareness, but these studies did not evaluate the long-term impact on patient experiences.

Future research could focus on what deaf awareness training is currently delivered to students and healthcare professionals in the NHS, the outcomes, and what factors affect uptake and success.