Impacts
The barriers to equitable employment identified in this review have significant impacts on the lives of deaf people and people with hearing loss, affecting their ability to work, wellbeing, and career progression.
Ability to work
Our review identified the Access to Work scheme as a key factor affecting people’s ability to work. These awards can be powerful facilitators of employment, enabling people to work who otherwise would not be able to, or who would have to significantly change their work.
RNID and DeafATW (2026) found that, over the 12 months preceding their survey, Access to Work awards had supported people to stay in work (73%), work desired hours (29%), do further education or training (13%), and start a new job (6%) or change employers (1%).
However, delays in provision lead to missed career opportunities, difficulty settling into roles, or even leaving jobs due to lack of communication support (SignHealth 2025). There is also evidence to suggest that the burden of the application process deters people from making decisions about their employment (RNID and DeafATW 2026). Some deaf people and people with hearing loss report nearly losing their jobs, or having dismissal processes triggered while waiting, as they are unable to fulfil the requirements of their role without appropriate support.
Renewal delays also affect people who are self-employed, as the uncertainty entailed in the Access to Work process prevents them from making business decisions (RNID and DeafATW 2026).
Disclosure
Past negative experience may result in deaf people and people with hearing loss being reluctant to inform employers about their hearing loss or communication needs. Unwillingness to disclose a disability or long-term condition can stem from fear of negative repercussions (Brewster 2017, Levitt 2024, Sheikh et al. 2021).
For example, graduates and young job seekers felt they were more likely to be offered interviews if they did not disclose their deafness or hearing loss when applying for jobs (Hall 2015). This may result in delays in accessing appropriate support. Conversely, inclusive work environments and supportive colleagues can help people feel more comfortable discussing their communication needs in the workplace (Lindsay 2022).
Wellbeing
Barriers faced in the workplace can affect wellbeing, causing anxiety and reduced confidence. In the most severe cases, negative experiences in the workplace can impact a person’s health, and ability to work (Henderson 2025, Hall 2015, Grote 2021, Lindsay 2022, Napier 2022, William 2016). In one instance, a person with hearing loss developed “phone phobia” due to difficulty using the telephone with high background noise in the office, combined with negative attitudes from co-workers. This led her to resign from her job and develop anxiety and depression (Hall 2015). In general, people with unmet access needs are more likely to experience burnout and depressive symptoms (Brown 2025).
“I lost my hearing in my late forties and felt ‘all at sea’ in my people-facing role. To such an extent that I demoted myself due to feeling so vulnerable. Instead, I began a job that was about identifying skills gaps and advocating for fairer working practices to support others. It’s a privilege to bring more awareness of inclusivity to the workplaces I support and, for me personally, having a supportive team who better understand my requirements – and are willing to be flexible in their approach – has been a real game changer.” – RNID storyteller Sally.
People who develop hearing loss during their careers may leave work or experience reduced confidence and wellbeing if they are not supported to adapt their role to their hearing loss (Heffernan 2022, Henderson 2025).
These effects can be particularly acute when circumstances place additional pressure on workplaces. During the COVID-19 pandemic, the lack of reasonable adjustments severely impacted deaf people and people with hearing loss working in healthcare. 14% of people surveyed were removed from patient-facing roles, and 40% felt they could no longer do the same role as prior to the pandemic, and multiple people reported a significant increase in anxiety (Grote 2021).
This suggests that policies designed to promote inclusion and accessibility may not be upheld in high pressure situations or crises, so that attention to practice under business-as-usual conditions may not capture the full picture of workplace inclusion.
Professional development and career progression
Access to training and professional development may be limited by the barriers identified in this review, such as difficulties obtaining support like reasonable adjustments and BSL interpretation.
Opportunities for career development are also affected by negative attitudes. 60% of people surveyed by the Royal Association for Deaf People reported experiencing barriers to career progression, which included a lack of role models, insufficient training and Continuing Professional Development (CPD) opportunities, low confidence, and low expectations from employers (RAD 2021b).
Deaf people and people with hearing loss experience anxiety because of inconsistent access to training and professional development opportunities. Communication needs may not be met when on training courses or at events such as conferences, even if the person has generally good support in their normal workday (Bevan 2013, Napier 2022).
Due to conditions or restrictions on current awards, 39% of people who are deaf, deafblind or have hearing loss have missed out on training opportunities (41% of deaf BSL users), 35% have attended fewer meetings or events, 22% have to work remotely more often than they would otherwise choose to. 53% of BSL users have had to adapt or change their work due to award caps (RNID and DeafATW 2026).
Changing jobs can also be challenging to manage alongside existing Access to Work awards. Deaf people report experiencing unnecessary reassessment, and cuts to essential support when they request a change of circumstances due to promotion, changing jobs, or becoming self-employed (SignHealth 2025, RNID and DeafATW 2026).
Access to Work recipients report being unclear what they should do when they make a career change (DWP 2018). Because of the Access to Work application process, 14% of people had decided not to do further education or training, and 13% had decided not to start a new job (RNID and DeafATW 2026).
Voluntary roles such as trustee positions which can support career progression are not covered by Access to Work, making them inaccessible to deaf sign language users (Business Disability Forum 2025).
Research also shows that workplace interactions are a key source of learning, including learning how to adapt to cultural expectations and organisational pressures. Without appropriate communication support, deaf awareness, and positive attitudes from colleagues, deaf people are likely to miss out on these informal learning opportunities (Barnes 2017).
When progressing to leadership roles, deaf people and people with hearing loss may experience higher demands but reduced support (Brown 2025, Brewster 2017). For example, expectations that more senior staff work longer hours or take a more prominent role chairing and leading meetings may be a barrier for deaf people and people with hearing loss without appropriate communication support, especially for people who already experience additional fatigue and demands on their time and energy at work (Brewster 2017).
Changing jobs or becoming self-employed can have unpredictable consequences for available support, for example if a new manager is less knowledgeable and supportive than a prior manager; this creates a “glass partition” preventing sideways movement (Roulstone 2013, RAD 2021b).
Barriers to career development and progression are likely to vary by sector, and there is a need for more research understanding how employment opportunities are affected by discrimination (Schwitter 2025). Different sectors will have different requirements for career progression. For example, for healthcare professionals, placements are an essential part of training, and the attitudes of educators and staff on placements can therefore affect whether a student can progress (Bevan 2013).
In academia, attending and presenting at conferences is a common factor in career progression, but these can be inaccessible (Lindsay 2022).
While these impacts cannot be generalised due to the heterogeneity of included studies and the small sample sizes of some studies, there is clear evidence that negative attitudes towards deaf people and people with hearing loss, and failures to provide sufficient support in the workplace, negatively affect the ability of deaf people and people with hearing loss to secure and maintain work, and progress in their careers. This is likely to be a key contributing factor to the unemployment and underemployment of deaf people and people with hearing loss.