Your patients with hearing loss

People with hearing loss often need to be persuaded to speak to their GP about their hearing difficulties. So it’s important to talk positively about getting hearing aids or the opportunity to help could be lost.

Your role as a GP

Because people trust you as their GP, it’s likely they’ll be more motivated to act on their hearing loss if you talk to them about the difficulties they’re having, the benefits of taking action sooner, and what to expect from hearing aids and hearing services. Remember, patients may appear to have normal hearing in a quiet consulting room. But if they report difficulty in other situations, they could be losing sensitivity to high frequency sounds. So, if a patient says they are struggling to hear, it’s important to give them a preliminary hearing assessment.

Preliminary assessments that you can carry out

Always perform an ‘otoscopy’ to check for wax and other outer and middle ear pathology.
A hearing check – this can be a handheld pure tone check or an or an audiometry screen at 25dB across 500hz, 1, 2 and 4 KHz.
A tuning fork can be used to assess for symmetrical hearing loss and whether it is conductive or sensorineural in nature.

A patient can be referred direct to audiology if they appear to have age-related hearing loss and none of the following additional problems (local protocols may vary slightly):

dizziness
single-sided hearing loss (unilateral hearing loss means an auditory nerve tumour or stroke MUST be excluded)
sudden hearing loss
ear infection
any other outer or middle ear pathology
occupational (noise-induced) hearing loss.

The impact of undiagnosed hearing loss

Evidence shows that hearing loss increases the risk or impact of various other long-term conditions, and many health conditions are associated with ageing, so are likely to occur alongside hearing loss. Research has also shown that hearing aids can reduce the risk or developing or the impact of some of these conditions.

Research has shown that hearing loss:

doubles the risk of depression
increases the risk of anxiety and other mental health issues
can lead to dementia – there is strong evidence to support this
in older people may lead to an increased risk in falls.

Research has also shown hearing loss to be linked with:

any form of diabetes
cardiovascular disease
stroke.

Evidence also suggests that up to 40% of people with a learning disability have some level of hearing loss and that it is often undiagnosed or misdiagnosed. For more information and evidence sources, see our Hearing Matters report.

Our Joining Up research outlined the evidence and showed why the diagnosis and management of other health conditions needs to take into account a person’s hearing loss, whether this is diagnosed or undiagnosed.

The report showed that hearing loss may lead to:

failed appointments
failed visits
misunderstanding of diagnosis or treatment
failure to take medication.

How hearing aids can help your patients

Hearing aids help people to communicate, to stay socially active and manage their own health. There’s also some evidence that they reduce the risk developing of depression and dementia.

Evidence suggests that hearing aids are most effective when fitted early, and that people with severe hearing loss find it more difficult to adapt to them. But people wait on average 10 years before seeking help and many people who could benefit from hearing aids do not have them. NHS England’s ‘Commissioning Services for People with Hearing Loss: A Framework for Clinical Commissioning’ states that GPs and other health professionals should routinely check peoples hearing as they get older.

Important aftercare information to give to patients

You can help patients, and their families or carers, start to understand how to take action on hearing loss by giving them our factsheets and leaflets to take away with them.

Our factsheets and leaflets cover:

hearing health (hearing loss, deafness, ear conditions and treatments)
tinnitus
hearing aids and cochlear implants
useful products and technology
communication tactics and support
benefits and grants
your rights.