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Local guidance

Meeting ear and hearing care needs



This section provides policymakers and NHS ICBs with information to help deliver high quality and cost-effective ear and hearing care services. Learn more about:

If you would like to access any additional support and guidance please email us at [email protected].

Hearing loss in your area

Today over 9.7 million adults have a hearing loss in England. Use the hearing map below to get an overview of hearing needs in your region.

Primary care audiology - accessible ear and hearing care for all

We are committed to working with sector partners, ICBs, NHS England and government to establish audiology as the fifth primary care service in England.

Primary care audiology will benefit patients and the NHS.


Allowing NHS patients to self-refer to primary care audiology will also reduce pressure on GPs and hospital colleagues - a win for patients, GPs and hospitals.


Learn more about primary care audiology - accessible ear and hearing care for all

Assessing ear and hearing care needs

The NCHA has worked in partnership with the NHS, LGA, PHE, Association of Directors of Public Health,RNID, the NDCS and public health experts to co-produce a Joint Strategic Needs Assessment (JSNA) guide and accompanying hearing loss data tool to help assess local needs and plan services accordingly.

These resources aim to support local authorities and NHS ICBs meet statutory duties to assess the needs of local populations, take account of health inequalities and commission high-quality services to meet local hearing needs and improve public health.

Commissioning high quality, cost-effective and sustainable services

The NHS National Commissioning Framework (NCF) for hearing loss services supports effective commissioning by:

  • Supporting NHS systems leads secure good value services for their local populations
  • Ensuring the needs of local people are met by high quality integrated care
  • Addressing access and outcome inequalities
  • Improving patient choice when it comes to selecting services
  • Contracting and monitoring outcomes and referrals from all providers to ensure consistency

You can:


This section can be read alongside other resources for policymakers and commissioners on our website. Commissioners in England might find the following resources helpful in that they provide independent evidence that:

  • Hearing loss is a major and growing health challenge
  • Early diagnosis and management of hearing loss is cost-effective and encouraged by NICE and NHS England
  • Hearing aids are cost-effective
  • Providing care closer to home can help improve access, quality and value for money



Originally published: 2015

Reviewed: February 2024

Next review date: February 2025

Info: This guide was updated as part of a website upgrade in 2021. New resources and links added in 2024. 

Reference and notes


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