A landmark report launched by charity Action on Hearing Loss revealed that there are now 11m people in the UK living with hearing loss. To put that in perspective – that’s one in six of your practice's patients. By 2035, due to our ageing population, that will increase to one in five.
Despite its prevalence, research shows that hearing loss presents a number of unique challenges for patients when accessing healthcare, including at GP practices. Our 2013 report Access All Areas? revealed that:
- The majority of patients with hearing loss (72%) contact their GP surgery by phone, yet just under half (44%) said this would be their preferred method of communication.
- Just under half (44%) said their GP surgery had a visual display screen.
- One in seven had missed an appointment because they hadn’t heard their name being called in the waiting room.
- More than one-quarter (28%) had been unclear about a diagnosis.
- Around one-quarter (26%) had been unclear about health advice they were given.
- Approximately one-fifth (19%) had been unclear about their medication.
Being patients’ first port of call gives GPs a huge responsibility – a responsibility that can't be properly fulfilled if practices are not fully accessible. If patients do not leave consultations feeling fully informed, this may lead to confusion over diagnosis and ineffective treatment.
Steps practices can take
One relatively simple step practices can takes is to enable patients with hearing loss to book an appointment without relying on telephones, which can create a significant barrier from the outset. Alternatives could include:
- Establishing an email address patients could use.
- Allowing patients to book appointments online and through SMS text.
- Making sure staff are aware of text relay services and providing a textphone number for patients to contact their GP and book appointments, and promoting the number.
Accessible information standard
Since 31 July 2016 all health and social care services have been required to meet the accessible information standard. Developed by NHS England with the help of Action on Hearing Loss, RNIB, Sense and CHANGE, the standard requires that all people with sensory loss and learning disabilities, including people with hearing loss, receive information in formats that they can understand, and that they receive appropriate support to help them communicate.
Its introduction also means that when a patient with hearing loss contacts their GP, they should be asked about their communication needs, and these should be recorded and flagged on their care record to prompt staff to take action. They should also be able to book a longer appointment if their hearing loss means that they need more time to properly discuss the issues they wish to raise.
Further steps practices should take include educating practice staff about how to communicate with patients with hearing loss, with at least one member of frontline staff knowing about deaf awareness and being responsible for this element of patient care throughout the practice.
Visual information should be displayed to let patients know when it’s their turn to see the doctor. Working hearing loops should be in place to help people communicate with receptionists or other members of staff. If a patient requires communication support such as a speech-to-text-reporter or notetaker, then this should be available for them on arrival.
Once in the consultation, it is important to ensure patients with hearing loss leave their appointments clear on any diagnosis, referral information or medication discussed. Some tips on the fundamentals of communicating with patients with a hearing loss can be found here.
For people who use British Sign Language (BSL), English may not be their main or preferred language, so they may need a qualified BSL interpreter or BSL video translation to ensure they can communicate with health professionals and understand written information.
There are a number of examples of patients being asked to bring family members and friends in for communication support, which is entirely inappropriate and has led to some terrible situations where relatives have had to translate confidential or distressing information – even cancer diagnoses.
To put this in perspective – 68% of respondents to our research had asked for a sign-language interpreter to be booked, but did not get one. While the accessible information standard will make an enormous amount of headway to ensure this no longer happens, some short deaf awareness training sessions will go a long to way to increase staff’s mindfulness of BSL-using patients.
Undiagnosed hearing loss
There’s another challenge GPs face when providing care for patients with hearing loss – there are high levels of undiagnosed hearing loss and many people wait too long to get their hearing tested.
People with hearing loss wait an average of 10 years before seeking help. Whether it’s due to the stigma of wearing a hearing aid, or simply because they feel it’s simply a ‘normal part of ageing’, many patients miss out on the huge advantages of wearing hearing aids.
Patients place an enormous amount of trust in their GPs and are far more likely to be motivated to take action on their hearing loss if during a consultation the benefits of wearing hearing aids sooner are explained.
The Action on Hearing Loss website also has a free hearing test to help identify people with hearing loss and encourage them to seek help.
Hearing loss was declared a major public health issue by the government in 2015. People with hearing loss have increased risk of social isolation and mental health issues including depression, and there’s also good evidence that people with hearing loss have an increased risk of developing dementia.
By embracing the changes the accessible information standard will bring, and by following a few simple steps, practices can greatly improve the service given to the 11m people living with hearing loss across the UK today.
- Tom Bailey is research and policy officer at Action on Hearing Loss