We all depend on hearing and communication to survive and thrive. Reduced hearing can make it difficult to communicate with other people as well as to hear important sounds such as traffic.

The good news is that with the right support at the right time, people don't have to be disadvantaged by reduced hearing.

Taking action can help improve quality of life by keeping people connected with family, friends and society. Reducing the risks associated with unsupported hearing loss leads to improved general health and wellbeing.

In the sections below you can learn about hearing and hearing care in the UK.

• Hearing and communication
• Reduced hearing
• Tinnitus and earwax
• Taking action
• Hearing health professionals
• Accessing hearing services
• NHS hearing care
• Private hearing care
• Prevention
• Other support

Hearing and communication

Most of us take our hearing for granted, even though we rely on it to survive and thrive. Few of us have regular hearing checks, yet

• we rely on our hearing to stay connected with the world around us, for example, through spontaneous conversation, group discussion, watching the news and listening to music
• hearing is the sense we use to detect traffic, alarms and other signals that keep us safe and
• hearing is closely integrated with mental processes such as memory, attention and cognition.

Most of us will experience changes in our hearing from middle age. For example, children and teenagers with good hearing can often detect pitches of sound that are completely inaudible to adults over the age of 30.

Our hearing range continues to reduce with age, reaching a point where it starts squeezing out some of the sounds important for clear speech. If you are experiencing reduced hearing, you are not alone. In fact over 11 million people in the UK have reduced hearing, but most don't know that something can be done to lessen the impact it has on quality of life.

The scale and impact of reduced hearing makes hearing care as important and relevant to society as dental care and sight care.

Hearing care professionals help people get the best hearing and communication outcomes by

• helping people optimise their hearing throughout life by assessing, protecting and enhancing it and
• sharing advances in alternative means of communication for those unable to depend on hearing.

In the UK, people can choose to access hearing care through the NHS or privately.

Reduced hearing

It is possible to have very good hearing for some pitches of sound while having difficulty with others. This leads to the sensation that sounds lack clarity, like a jigsaw puzzle with pieces missing. The more pieces of sound there are missing, the harder it becomes to hear.

If our ability to hear is reduced, some or all of the sounds that other people can hear may become inaudible to us. Reduced hearing ability can make it difficult to follow conversations or detect important sounds in the environment.

For the majority of people the main difficulties that arise from reduced hearing are social. For example

• in all areas of life we generally expect others to hear and understand us. When we are unable to hear and cannot participate in conversations as expected, it can put us at a disadvantage socially, professionally and psychologically

• hearing connects us to each other. Qur reduction in hearing can impact on the people we communicate with, especially those closest to us.

This is why, if left unaddressed, reduced hearing can have a real impact on general health and wellbeing. For example, someone may begin by finding background noise difficult and start avoiding such situations, which might reduce their opportunities to socialise with family, friends and colleagues. This increases the risk of depression, social isolation and loneliness, which in turn may increase the risk of cognitive decline.

The good news is that with the right care at the right time, nobody has to be disadvantaged by reduced hearing. Taking action can help improve quality of life by keeping people connected to friends, family and society. This can also reduce the impact unsupported hearing loss has on general health and wellbeing of those with reduced hearing and those around them.

Tinnitus and earwax

Tinnitus

Tinnitus is the perception of sound in the absence of sound from the environment.

It might be described as a 'ringing in the ears' - in fact tinnitus comes from the Latin word for 'ringing'. However not everybody with tinnitus experiences a ringing sensation. Some people, for example, might experience a buzzing, humming or grinding sound.

The impact of tinnitus varies from person to person. For some people it is not bothersome but for others it can have a severe impact on their quality of life.

Tinnitus is commonly associated with hearing loss although it is not commonly associated with other underlying physical problems, according to NICE guidelines.

Therefore, if you are experiencing tinnitus, you can contact your local hearing care provider for a hearing assessment, advice and support.

Read more about tinnitus on www.nhs.uk

Earwax

Earwax is a natural substance produced to lubricate and protect the ears.

If there is a build-up of earwax this can cause problems such as reduced hearing, the feeling of blocked ears, earache and tinnitus.

Many hearing care providers now provide earwax management services closer to home and in community settings out of hospital. If you want help with impacted earwax, you can contact your local hearing care provider. 

Read more about earwax on www.nhs.uk.

Benefits of taking action

Hearing checks can help identify the cause of reduced hearing and help achieve the best possible hearing and communication outcomes.

Hearing technology, such as hearing aids and other devices, can help restore the audibility of missing sounds by bringing back specific sounds into a person's hearing range. This helps maintain a person's ability to hear as expected and communicate effectively, which can improve their general wellbeing and quality of life.

For many people, appropriately prescribed and fitted hearing aids will be sufficient. For other individuals, changes to the environment or informing those around about how to improve communication may be required.

Similarly, if the environment or situation can be altered to reduce reliance on hearing, the impact of any reduction in hearing can be minimised. Examples include the use of captions/subtitles on TV, public announcements shown on a screen, making sure the speaker's face is visible; and the acoustic treatment of public places to reduce reverberation and background noise.

Each individual has different communication needs based on their lifestyle and the cause and level of reduced hearing. Hearing care professionals consider the impact of reduced hearing at an individual level and offer advice, support and/or technology to improve each person's quality of life.

Hearing care in the UK

Reduced hearing can be temporary or permanent. Having a hearing check can help identify the cause of reduced hearing and help achieve the best possible outcomes.

Most people experience a gradual reduction in hearing. This means most people will find it difficult to recognise whether they are missing particular sounds because changes occur over many years. This is why routine hearing checks are important.

In the UK adults can 

• Access NHS funded ear and hearing care services or 
• Self fund their ear and hearing care.

Occasionally someone may experience a sudden reduction in hearing, in which case it is important to see a qualified healthcare professional as soon as possible.

Some people are also born with reduced hearing. To learn more about newborn screening you can watch this NHS video.

It is important to always seek professional support if you have concerns about your hearing.

Hearing health professionals

There are many professions that work in the field of hearing care. The table below provides an overview of various hearing specialists and doctors that work in the UK.

Hearing specialists - non-medical.

Hearing specialists - medical

Accessing Hearing Services

In the UK people have a choice about whether they access hearing care through the NHS or privately

• in most regions, people that choose to access hearing care on the NHS currently have to see their GP for a referral to a Hearing Care Professional
• people can choose to access hearing care privately in the same way that they access sight and dental care. People that choose private hearing care do not have to wait until they have a problem to have a hearing check.