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Hearing loss in adults: assessment and management - NICE guideline

This guideline, developed by the National Guideline Centre (NGC) and hosted by the Royal College of Physicians (RCP), covers the assessment and management of hearing loss in adults.

Difficulties in hearing can arise from simple problems, such as earwax which blocks the ear canal and can be treated in primary care, through to potentially life-threatening conditions, such as autoimmune disease which needs specialist medical care. The majority of hearing loss is age-related and is well managed with hearing aids without the need for medical care.

Hearing loss in adults: assessment and management aims to identify the correct routes of referral and provide the best management pathway for people with hearing loss


Recommendations in the new NICE guideline include:

Referral for care:

  • the need for early audiological assessment of people with hearing loss
  • identifying which people with hearing loss require medical care as well as audiological care, to whom they should be referred and how quickly
  • proactive referral of people with dementia, mild cognitive impairment and learning disabilities


  • removing earwax in primary and community care
  • criteria for MRI for hearing loss
  • conducting an audiological assessment
  • offering and fitting hearing aids
  • explaining how to use noise reduction features such as directional microphones
  • providing information about assistive listening devices
  • follow-up in audiology services
  • how to support people with hearing loss and improve their access to care