Community audiology
A Westminster Hall debate on community audiology will take place on Thursday 18 December. The debate was scheduled by the Backbench Business Committee and will be led by Danny Beales MP.
Community audiology services provide support and treatments to improve people’s hearing health, such as if they have hearing loss. In 2024, the proportion of people reporting deafness or hearing loss in England was 5.8%.
Most NHS audiology services are locally commissioned by Integrated Care Boards (ICBs), except some specialised services, such as specialised ear surgery (cochlear implantation), which is commissioned by NHS England. Some ICBs enable people to self-refer to community audiology. Some community audiology services also include a balance service (called a vestibular service) to check if symptoms such as vertigo or balance issues are related to inner ear issues.
The government’s 10 year health plan for England, published in July 2025, said that, in the future, people will be able to self-refer to clinical audiology (where clinically appropriate) using the NHS App.
Types of hearing lossThere are three types of hearing loss:
- Conductive, which involves the outer or middle ear and occurs when sound cannot pass through to the cochlea (part of the inner ear, which helps a person to hear) due to a blockage.
- Sensorineural, which involves the inner ear and is “caused by damage to the hair cells inside the inner ear, or damage to the hearing nerve, or both”. Damaged hairs do not send electrical signals well, meaning sounds (typically high-pitched sounds) can seem muffled.
- A mixture of conductive and sensorineural hearing loss.
Hearing loss that develops, and worsens, with age is common and is known as presbycusis.
The NHS explains that “aging or damage from loud noise over many years, ear infection, earwax build up and a perforated eardrum” (such as from a change in air pressure) are common causes of hearing loss. It also lists Labyrinthitis (a type of inner ear infection) or Ménière’s disease (a rare type of inner ear infection) as causes of sudden hearing loss.
According to the Royal National Institute for Deaf People (RNID), exposure to loud noise is the second biggest cause of hearing loss, after aging. Hearing loss can be caused by being around loud noises over time (for example at work) and from short blasts of noise, like an explosion.
There are other, less common causes of hearing loss. These include autoimmune inner ear disease, which occurs when the body’s immune system attacks cells in the inner ear which it mistakes for a virus or bacteria, and acoustic neuroma, a type of non-cancerous brain tumour that grows on the nerve which connects the inner ear to the brain and is relied upon for hearing and balance.
TreatmentsGPs may be able to treat various causes of hearing loss, such as antibiotics for an ear infection or ear drops or wax removal for earwax build up.
Permanent hearing loss may require hearing aids or hearing implants.
Challenges associated with hearing lossA recent report by RNID and SignHealth found that those with hearing impairments were less able to take up health treatment or engage with healthcare due to a lack of accessible communication across the NHS: Still Ignored: the fight for accessible healthcare (2025).
NHS England published a revised Accessible information standard in July 2025, which NHS and adult social care services must adhere to.
There have also been reports stating there is a significant attainment gap for deaf children in school. In March 2023, a report by the Education Policy Institute found that deaf children are, on average, almost a year and a half behind their classmates in learning, and attain lower GCSE grades on average. The Royal Association for Deaf people published a report in April 2021, which found that this attainment gap, as well as a lack of accessible information, affected career opportunities and progression for deaf people (pdf).
Stakeholder commentary about community audiology services The Kingdon ReviewThe Kingdon Review was published on 10 November 2025. It was commissioned by the government about children’s audiology services, although the review stated its findings were relevant across all audiology services, including adult audiology.
The Kingdon review stated that children’s audiology services are “often overlooked, undervalued and underfunded”, calling it a ‘Cinderella’ service. The review found that communication on known service issues in hearing services between Department for Health and Social Care (DHSC) and NHS England didn’t follow expected standards, and there is no audiology lead in DHSC to take the lead on such matters.
The review found that service quality was patchy, with little data collection on audiology services to determine how well a service may be doing. Service delivery was found to be very variable, which subsequently meant outcomes were also very varied. Hearing services also suffered from a lack of oversight from ICBs and regulators. The review also found that uniform professional standards and recruitment strategies around audiology was lacking. The Kingdon review made 12 recommendations across three themes:
- Understanding the scale of the current problem.
- Placing these services on a secure footing for the future.
- Applying the lessons learned to similar services.
RNID also published a report in March 2024 on the state of UK audiology services (PDF). The report said in recent years audiology services had reduced capacity due to staff shortages and inadequate funding, that had been exacerbated by the impact of the pandemic. RNID recommended:
- Healthcare providers should implement accessible information standards
- Ear wax removal services to meet population need
- NHS providers to test and scale various measures improve adult hearing, such as service flexibility and using technology such as Bluetooth
- More investment in innovation for audiology to trial and pilot new initiatives and evaluate their impact
In September 2025, RNID published a report titled Hearing Care Reimagined (PDF). The report provides details of various technology innovations that RNID says could help improve audiology care services by:
- Identifying early signs of hearing loss
- Supporting quicker diagnosis of hearing loss
- Making it easier for people to get support
- Empowering people to manage their hearing health
11 January 2024 | House of Commons | 743 cc477-525
12 December 2023 | Westminster Hall | 742 cc232WH-239WH
Parliamentary QuestionsAudiology: Community Health Services
13 November 2025 | HL11607
Asked by: Lord Kamall
To ask His Majesty's Government what discussions they are having with integrated care boards about commissioning community audiology services in all areas in England.
Answering member: Baroness Merron | Department: Department of Health and Social Care
Community audiology services are commissioned by integrated care boards (ICBs). The priorities and operational planning guidance states that systems are expected to put in place self-referral routes to community audiology services.
To raise awareness of self-referral to audiology services, NHS England is adding information on the relevant condition specific pages on the NHS.UK website. ICBs are responsible for ensuring that patients have the information they need to make decisions about their care, including if they have the option to self-refer to locally commissioned services.
Hearing Impairment: Children and Young People
21 October 2025 | UIN 77507
Asked by: Jim Shannon
To ask the Secretary of State for Health and Social Care, what information his Department holds on the number of people aged under 21 who have been diagnosed as legally deaf in the last 12 months.
Answering member: Dr Zubir Ahmed | Department: Department of Health and Social Care
The information requested is not held centrally.
The Office for National Statistics collates data on deaf adults, but not on deaf children. It estimates in its 2022/23 annual population survey that 1,235,855 adults aged 16 years old and over in the United Kingdom have difficulty in hearing. These statistics are available at the following link:
However, other organisations have data or estimates of the number of deaf children and young people. For example, the Consortium for Research into Deaf Education, which brings together a range of organisations with an interest in improving the educational outcomes achieved by deaf children, identified in its 2024 report that there were 54,321 deaf children reported by services across the UK, a 3% increase since 2023. The report is available at the following link:
https://cms.ndcs.org.uk/sites/default/files/2025-05/CRIDE%20UK%20-%202024.pdf
NHS audiology services are locally commissioned, and the responsibility for meeting the needs of non-hearing people lies with local NHS commissioners. We expect local commissioning to be informed by the best available evidence, relevant National Institute for Health and Care Excellence guidelines, and guidance issued by NHS England. In 2019, NHS England, with input from the National Deaf Children’s Society, produced a guide for commissioner and health and local authority providers who support children and young people with hearing loss. This guide is available at the following link:
https://www.england.nhs.uk/wp-content/uploads/2019/11/what-works-chswg-guide.pdf
Hearing: Testing
17 October 2025 | UIN 78910
Asked by: Liz Jarvis
To ask the Secretary of State for Health and Social Care, what assessment he has made of the effectiveness of NHS England’s processes for (a) identifying and (b) responding to concerns about the (i) quality and (ii) accuracy of children’s hearing test services; and what steps his Department is taking to improve the (A) consistency and (B) reliability of children’s hearing tests.
Answering member: Karin Smyth | Department: Department of Health and Social Care
In December 2021, a report was published into service issues in children’s hearing services in NHS Lothian. The report focused on whether children’s hearing tests were being conducted properly and were effectively followed up. Further problems with the diagnosis of hearing issues in newborns and children were identified in other Scottish NHS trusts in 2023.
Subsequent assessment of NHS hearing services in children’s departments across England in 2023 and 2024 identified similar problems. In 2023, NHS England established the Paediatric Hearing Services Improvement Programme to address the issues and oversee remedial action.
In April 2025, my Rt. Hon. Friend, the Secretary of State for Health and Social Care, appointed Dr Camilla Kingdon to chair an independent review into children’s hearing services. The review has considered:
- NHS England’s response to the service failures in children’s hearing services;
- how the relevant governance arrangements between the Department and NHS England could be improved, and identify lessons learned; and
- how NHS England’s handling of any future service failures in similar services could be improved, and identify lessons learned.
The Department is currently considering next steps and how to ensure lessons learned can be acted upon promptly, including whether steps need to be taken to improve both the consistency and reliability of children’s hearing tests.
NHS England is supporting provider organisations and integrated care boards who are the commissioners of audiology services to improve performance and reduce waiting lists for appointments and assessments for hearing services. This includes capital investment to upgrade audiology facilities in NHS trusts, expanding audiology testing capacity via community diagnostic centres, and directing support through a national audiology improvement collaborative.
Audiology: Waiting Lists
22 July 2025 | UIN 68208
Asked by: Michelle Welsh
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to reduce waiting lists for (a) appointments and (b) assessments for hearing services.
Answering member: Karin Smyth | Department: Department of Health and Social Care
Cutting elective care waiting times, including for hearing services, is a key priority for this government. We have now exceeded our pledge to deliver an extra 2 million operations, scans, and appointments, having now delivered 4.6 million additional appointments.
We are committed to transforming diagnostic services and will support the NHS to increase capacity to meet the demand, including for audiology services such as hearing tests. Our Elective Reform Plan commits to transform and expand diagnostic services and speed up waiting times for tests.
NHS England is supporting provider organisations and integrated care boards (ICBs) who are the commissioners of audiology services to improve performance and reduce waiting lists for appointments and assessments for hearing services. This includes capital investment to upgrade audiology facilities in NHS Trusts, expanding audiology testing capacity via Community Diagnostic Centres, and direct support through a national audiology improvement collaborative.
Audiology: Children
27 February 2025 | UIN 31086
Asked by: Layla Moran
To ask the Secretary of State for Health and Social Care, what steps he is taking to help ensure that ICBs are providing clear and consistent guidance on help for deaf children in developing language and communication skills.
Answering member: Stephen Kinnock | Department: Department of Health and Social Care
Integrated care boards (ICBs) in England are responsible for commissioning services to meet the health needs of their local populations, including services for non-hearing children. NHS England supports ICBs to make informed decisions about the provision of audiology services so that they can provide consistent, high quality, and integrated care to non-hearing children.
In 2019, NHS England, with input from the National Deaf Children’s Society, produced a guide for commissioners and providers who support children and young people with hearing loss. The guide provides practical advice on ensuring non-hearing children receive the support they need. In July 2016, NHS England published Commissioning Services for People with Hearing Loss: A Framework for Clinical Commissioning Groups. This framework supports ICBs to make informed decisions about what is good value for the populations they serve and to provide more consistent, high quality, integrated care, including for children with hearing loss. It also addresses inequalities in access and outcomes between hearing services.
The National Institute of Health and Care Excellence’s (NICE) prioritisation board considered childhood hearing loss as a potential guideline topic last August, but concluded that there is limited evidence available in this area and that the NHS England Action Plan on Hearing Loss addresses care for this population. Later this year, the NICE’s prioritisation board will consider if it should develop a guideline on paediatric audiology following a topic suggestion. It will also consider if the NICE should update its technology appraisal guidance on cochlear implants for children and adults.
Press materialIs the Kingdon Review a wake-up call for NHS audiology services? (RNID, 10 November 2025)
Blackpool children's hearing services halted over safety failings (BBC News, 10 July 2025)
Newcastle MP addresses hearing service 'postcode lottery' concerns (Chronicle Live, 17 April 2025)
Six voices on the call for primary care audiology services (Optometry Today, 11 November 2024)
“It’s time to talk about hearing,” says Specsavers (Optometry Today, 2 July 2024)
Further readingKingdon review of children’s hearing services: final report (Department of Health and Social Care, 10 November 2025)
Accelerating innovation in hearing care (RNID, 10 September 2025)
Access to Care: The benefits of eye and hearing care in the community (August 2025, Specsavers UK)
It's time to talk about hearing: hearing health report 2024 (September 2024, Specsavers UK)
Investigating Variation in NHS Hearing Aid Services: A Research Note (RNID, 2024)
Speak Easy (RNID, 2020)
Valuing Audiology (RNID, 2019)