NICE guidelines

Each year the NCHA policy teams analyses and responds to key National Institute for Health and Care Excellence (NICE) consultations to ensure hearing needs are taken seriously – see our policy submissions. Below you will find links to key NICE documents covering hearing loss, hearing problems and tinnitus.

If you have any comments on this resource or would like to suggest adding links to other NICE guidelines please email [email protected].

Main guidelines for audiology

Hearing loss in adults: assessment and management [NG98]

This NICE guideline covers assessing and managing hearing loss in primary, community and secondary care. It includes advice on assessing hearing difficulties, referral criteria, as well as details on managing earwax in adults.

An independent economic analysis supporting this guideline shows that hearing tests and aids are very cost-effective interventions. NICE therefore recommends that adults are encouraged to seek help with hearing problems sooner rather than later, as this has the potential to improve quality of life and reduce the risks associated with unsupported hearing loss.

This guideline is supported by a NICE quality standard (QS) which aims to help implement key lessons from the guideline above. QS185 describes high-quality care and priority areas for improvement in hearing care for adults.

The NCHA made significant contributions to this NICE guideline and QS through the formal consultation process, helping ensure the final guideline is evidence led and works in the best interests of patients and the NHS. The NCHA has therefore formally supported the NICE QS.

Tinnitus: assessment and management [NG155]

This NICE guideline covers the assessment, investigation and management of tinnitus in primary, community and secondary care.

The NCHA made significant contributions to this NICE guideline through the formal consultation process, helping ensure the final guideline is evidence led and works in the best interests of patients and the NHS.

Cochlear implants for children and adults with severe to profound deafness [TA66]

This technology appraisal [TA66] sets out the eligibility criteria for NHS funded cochlear implants in England. It was updated in 2019 after reviewing the criteria for defining severe to profound deafness and for assessing adequate benefit from acoustic hearing aids.

It is helpful in designing local referral protocols to ensure people can make informed choices about their care and access an assessment for cochlear implants when this is in their best interest and they choose to do so.

Other

Medtech innovation briefings (MIBs)

MIBs are not NICE guidance and do not constitute a guidance recommendation. They are pieces of work commissioned by the NHS in England with the goal of accelerating innovation in new treatments and diagnostics. Members might be interested in the following MIBs

General health and wellbeing guidance linked to hearing loss

These guidelines can be used by community audiology to support service users, aid multidisciplinary working, and promote awareness of the importance of hearing care across health and social care. Doing so can also help address health inequalities that people with unaddressed hearing loss are more likely to suffer.

Dementia: assessment, management and support for people living with dementia and their carers [NG97]

This NICE guideline aims to improve care by making recommendations on training staff and helping carers to support people living with dementia. It sets out how service providers should design services to be accessible to as many people living with dementia as possible, including those with “sensory impairment (such as sight or hearing loss)”

It goes on to recommend that the NICE guideline on the management of hearing loss (NG98) is followed. NG 98 recommends that clinicians should:

“Consider referring adults with diagnosed or suspected dementia or mild cognitive impairment to an audiology service for a hearing assessment because hearing loss may be a comorbid condition”
“Consider referring adults with diagnosed dementia or mild cognitive impairment to an audiology service for a hearing assessment every 2 years if they have not previously been diagnosed with hearing loss”
“Consider referring people with a diagnosed learning disability to an audiology service for a hearing assessment when they transfer from child to adult services, and then every 2 years”

Multimorbidity: clinical assessment and management NICE guideline [NG56]

This guideline covers optimising care for adults with multiple long-term conditions (multimorbidity). Its goal is to identify people most likely to benefit from an approach to care that takes account of multimorbidity and aims to improve quality of life in this group. The key point to note is the definition of multimorbidity includes hearing loss:

“Multimorbidity refers to the presence of 2 or more long-term health conditions, which can include […] sensory impairment such as sight or hearing loss.”

Mental wellbeing in over 65s: occupational therapy and physical activity interventions [PH16]

This guideline is focussed on practical actions people can take to improve mental wellbeing in adults aged 65 and older. It recommends that there should be an attempt to increase older people’s knowledge about where to access reliable information, including inviting local advisers to give informal talks on topics such as maintaining healthcare needs such as hearing and sight care.

Older people: independence and mental wellbeing [NG32]

This includes interventions to maintain and improve the mental wellbeing and independence of people aged 65 or over and how to identify those most at risk of a decline.

It defines hearing loss as an age-related disability and recommends:

“activities are inclusive and take account of a range of different needs (for example, think about the needs of older people with an age-related disability)”
staff in contact with older people should be able to identify those most at risk of a decline in their independence and mental wellbeing, which includes people with an age-related disability.

Care and support of people growing older with learning disabilities [NG96]

This guideline is focussed on helping people access the services they need as they get older.

It recognises that “adults with learning disabilities are far more likely to have sensory impairment compared with the general population, but are less likely to access sight or hearing checks, particularly if they are living independently or with family.” It also states that “sensory impairment is also a barrier to accessing services”.

It suggests training for people and their family members and carers in recognising changes and managing age-related conditions such as hearing loss and sight problems and how to access services such as hearing tests and sight tests.

Mental wellbeing of older people in care homes [QS50]

This quality standard covers the mental wellbeing of people aged 65 and over receiving care in care homes. Its main goal is to improve mental wellbeing and in turn to support good health and independence. It sets out how it is important to meet hearing needs in this population as follows:

“Mild but progressive sight and hearing losses are a common feature of ageing and may go unnoticed for some time, but can have a serious effect on a person’s communication, confidence and independence. The recognition and recording of needs arising from sensory impairment by staff who are alert to the symptoms and signs and aware of the role of the GP in the route to referral can help to ensure early assessment and access to appropriate healthcare services. For older people in care homes this is essential to improve their quality of life and avoid isolation, which can have a detrimental effect on mental wellbeing.

Quality measures Structure Evidence of protocols to ensure that staff are trained to recognise specific needs arising from sensory impairment in older people, and record these needs as part of their care plan”

Older people with social care needs and multiple long-term conditions [NG22]

This guideline covers planning and delivering social care and support for older people who have multiple long-term conditions. It sets out the need to address sight, hearing and communication needs. It also goes on to raise awareness about hearing loops and TV listeners as well as recognising and supporting common conditions such as hearing and sight loss.

Delirium: prevention, diagnosis and management [CG103]

This guideline advises clinicians and carers to ensure that they resolve any reversible cause of sensory impairment such as impacted ear wax, and that people have access to working hearing and visual aids as clinically necessary.

Medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence [CG76]

This guideline covers how to encourage medicines adherence in adults. It makes clear that good communication between healthcare professionals and patients is critical in this process and encourages clinicians and others to consider factors such as sight or hearing problems which might have an adverse impact during a consultation.

Similar guidance is set out in managing medicines in care homes [SC1]

Decision-making and mental capacity [NG108]

This guideline aims to help health and social care practitioners support people to make their own decisions where they have the capacity to do so. It states that when giving information “it should be supported by tools such as visual materials, visual aids, communication aids and hearing aids, as appropriate”.

Important guidelines and standards in development

Adults with lifelong or very severe hearing or visual impairment: health, well-being and social care. Status, awaiting development. Read more.

Digital hearing aids. Status, awaiting development. Read more.

NICE health technology evaluations: the manual (HealthTech update). Status, in development. Read more.

Withdrawn guidelines

Hearing disability [TA8] – hearing aids originally published 23 July 2000. It was withdrawn from May 2003 following the Department of health making digital hearing aid technology available across the NHS.

Keeping up to date

NICE guidelines are officially written for England only. There is, however, a Service Level Agreement in place in Wales. Decisions on whether to adopt these guidelines in Northern Ireland or Scotland are made on a case by case basis. For example, Northern Ireland fully endorsed NG98 in 2018.

The summary above only includes key NICE guidelines which members are likely to find most helpful, it should not replace keeping up to date with audiology and ENT developments on the NICE website. Search for hearing specific issues on the NICE website.

Updates

Originally published: 2016

Reviewed: December 2025

Next review date: December 2028

Reference and notes

This guidance was reviewed in December 2025. No material changes were made to the text. There was some minor rewording for clarity. Links were updated to reflect updates in guidance and new guidance in development. The guidance will be reviewed again in December 2028.

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