Download Everything you need to know about getting hearing aids

Everything you need
to know about getting
hearing aids
Everything you need to know about
getting hearing aids
This factsheet is part of our Hearing aids range. It provides full information on getting hearing
aids, whether you choose to go through the NHS or a private hearing aid dispenser. You’ll find it
useful if you’re experiencing hearing loss and are considering getting hearing aids, or if you
currently have hearing aids and want to learn more. You’ll also find it helpful if you’re adjusting to
new hearing aids – it can take time for them to feel comfortable, but please do persevere.
To find out more about hearing aids for children, please contact the National Deaf Children’s
Society (NDCS) – see page 19 for contact information.
If you’d like this factsheet in large print, Braille or audio format, please contact our helpline – see
front page for contact details.
In this factsheet we answer the following questions:

What should I do if I think I have hearing loss?
3

Where will I have my hearing assessed?
3

What will happen at my hearing assessment?
5

What happens if I get my hearing aids on the NHS?
5

What are the different types of hearing aid?
7

What are some useful hearing aid features?
8

What questions should I ask the audiologist?
10

What is loudness recruitment and how can digital hearing aids
help manage the problem?
10

How do I service my hearing aids and get new batteries?
11

Can I get spare hearing aids?
12

What should I do if my hearing aids aren’t helping?
12

What are the common problems?
12

What is Hear to Help?
14

What should I consider if I’m thinking of buying hearing aids?
14

How much will my hearing aids cost?
14

How do I choose a private hearing aid dispenser?
15

How do I decide which hearing aids to buy?
15

I have severe hearing loss – will it be harder to find suitable hearing aids?
16

What will happen when I go to a private dispenser?
16

What should I check before signing the agreement to buy?
16

Can I get my money back if I’m not happy?
17
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
2

How long are my hearing aids guaranteed for?
17

What should I do if I have a problem with the hearing aids I’ve bought?
17

What if I want to make a complaint about an NHS audiology department?
18

Where can I get further support?
18

Can I buy hearing aids abroad?
19

Where can I get further information?
19
What should I do if I think I have hearing loss?
Take our Hearing Check
If you’re struggling to hear as well as you used to, taking our Hearing Check is a quick and easy
way to find out if you could have hearing loss – just call 0844 800 3838 to take the test over the
phone, or visit our website at www.actiononhearingloss.org.uk/hearingcheck to take the test
online. If the check indicates that you could have hearing loss, the next step is to contact your GP,
who will see if you need further medical examination or treatment.
See your GP
Your GP will be able to rule out any temporary causes for your hearing loss, such as a build-up of
wax or an ear infection, which can easily be treated. See our Ears and ear problems range of
factsheets for more information about different causes of hearing loss. You can download these at
www.actiononhearingloss.org.uk/ears or order them from our helpline (see front page for details).
Once your GP has ruled out any temporary causes for your hearing loss, they should refer you to
an audiologist (a specialist who deals with hearing and balance disorders) for further tests. You
may need to convince your GP about the problems that your hearing loss causes, and you might
have to insist on being referred to an audiology service for a full assessment. Remember: you
have the right to have your hearing assessed, especially if your hearing loss is affecting
your everyday life.
Where will I have my hearing assessed?
Your GP will either refer you to:
 a hospital ear, nose and throat (ENT) clinic – where you will see an ENT doctor and an
audiologist
 the audiology department at a local hospital – this is called ‘direct referral’ and means that
you won’t have to join a waiting list to see the ENT doctor first. You will, however, still have to
wait up to six weeks for an appointment
 an audiology clinic – some GPs arrange for audiologists to visit their surgery or health centre
to run a clinic, so you may be able to have your hearing assessed there
 another qualified provider of adult audiology services (you get to choose) – this option is
available in England only, and not in every area; you’ll also need to meet certain criteria to have
this choice (see the box ‘What is Any Qualified Provider?’ overleaf).
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
3
Of course, you may decide to have your hearing assessed privately by a private hearing aid
dispenser. If this is the case, you don’t have to be referred by a doctor or an ENT specialist; but it
may be advisable to see your GP first to rule out any temporary causes for your hearing loss.
If the ENT, audiology department or private hearing aid dispenser finds that you are losing your
hearing, you may be offered hearing aids if they think that you’ll benefit from them. We explain
what’s involved when you buy hearing aids privately from page 14 onwards. If you decide to buy
hearing aids privately, you are still entitled to free NHS hearing aids.
What is Any Qualified Provider?
The Any Qualified Provider (AQP) scheme was introduced in April 2012, as part of the
government’s health reforms in England. It means that any healthcare provider in England,
including the NHS, third-sector organisations and private companies, can deliver certain NHS
services – including adult hearing services – providing they meet NHS quality requirements,
prices and contracts.
Is AQP in my area?
It’s not compulsory for adult hearing services in England to be delivered through AQP; the decision
will be made locally. To find out what services in your area are affected by AQP, speak to your GP
or visit www.nhs.uk/aqp
What will this mean for me?
Only people aged over 55 who have suspected age-related hearing loss, with no balance
problems or troublesome or one-sided tinnitus, will be eligible for referral to adult audiology
services through AQP. If you meet this criteria and AQP is available in your area, you’ll be able to
choose which hearing service provider (from a list of qualified providers) you are referred to.
What if I’m unsure about which service to choose?
You may need some time to decide. Things you may want to consider when choosing a service
include: waiting times for an appointment, location of service (is it close to home?), ongoing
services and support offered. You can also visit our Locate and Rate page on our website, which
lets you search for all the audiology services within your area and see ratings and comments
made by people who have visited the services: www.actiononhearingloss.org.uk/locateandrate
Whoever delivers the service, all care and treatments, including any NHS hearing aids you
receive, will remain free.
The government hopes that giving you the opportunity to choose which service provides your
audiology care will lead to an improvement in the quality of the service.
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
4
What will happen at my hearing assessment?
Your first appointment
For any medical check, it’s useful to have someone with you for support and to make sure you
don’t mishear anything. Your ears will be examined for obvious signs of damage or disease and
you will be asked about your medical history.
An audiologist will assess your hearing, one ear at a time. Some hearing tests may be carried out
with a tuning fork. These tests will find out which ear has greater hearing loss and which type of
hearing loss it is. The range of tests carried out during a consultation can vary, but they must
include an air conduction hearing test. In this test, you listen to tones (beeps) through
headphones and tell the audiologist when you can hear them. The tones are musical notes of low,
middle and high frequency (pitch). The audiologist will gradually make them quieter and record the
softest sound that you can hear at each frequency. This is known as the ‘threshold’ of hearing. If
this test shows that you have some hearing problems, the audiologist will carry out a bone
conduction hearing test. In this test, you wear a special headband with a vibrating pad that
conducts sound through the bones of your skull directly to the cochlea in your inner ear. Again,
you have to press a button each time you hear a sound. If you can hear sounds in this test that
you couldn’t hear in the headphone test, it suggests that your hearing loss is caused by problems
in your outer or middle ear (and that your inner ear is working better than the outer and middle
ear). This is known as ‘conductive hearing loss’. If your level of hearing loss is the same in both
tests, it suggests that you have sensorineural hearing loss, which is caused by damage to the
cochlea or hearing nerve. For more on the different forms of deafness and hearing loss, see our
Ears and ear problems range of factsheets and our leaflet Understanding your ears.
If the audiologist finds that hearing aids would help you, they will discuss options with you, which
will depend on your type of hearing loss. If you are offered two aids – one for each ear – you might
be given one aid first to give you time to get used to it before the second one is fitted.
If you decide to get your hearing assessed privately, you do not need a referral from your GP.
However, we would advise that you see the GP first to rule out any possible underlying causes for
your hearing loss, such as an infection or wax. We strongly recommend that you have a friend or
relative present when you see the private audiologist to help make sure you don’t feel pressured
into buying hearing aids.
What happens if I get hearing aids on the NHS?
The NHS buys a range of hearing aids and uses its bulk buying power to get good-quality digital
hearing aids at low prices from hearing aid manufacturers. The audiology departments provide
these aids free of charge on long-term loan to NHS patients. Digital hearing aids are fitted
routinely on the NHS, since our successful campaign to modernise NHS hearing aid services.
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
5
Hearing aids provided by the NHS usually fit behind the ear. They have an earmould that connects
to the hearing aid and fits in your ear. There is an alternative way of fitting behind-the-ear (BTE)
hearing aids that doesn’t involve an earmould. This is called an ‘open ear fitting’ and uses a
thinner tube and a smaller, soft earpiece at the tip of the tubing instead of an earmould. Openfitting hearing aids are now also fitted routinely on the NHS. These fittings can be less visible than
earmoulds and can give you a more natural sound, but they are only suitable if your hearing loss is
mild or moderate. Some audiology departments are also beginning to issue receiver-in-the-canal
aids. They look similar to open fitting aids, but are more suitable for severe hearing loss.
Disposable and in-the-ear hearing aids are not normally available from the NHS – most will not be
suitable if your hearing loss is severe. See page 7 for more information about the different types of
hearing aid.
N.B. – The NHS and the private sector are completely separate. Although the hearing aids come
from the same manufacturers, you can’t get financial help from the NHS to buy hearing aids
privately. However, if you do buy them privately, you are still entitled to NHS hearing aids.
It’s highly likely that you’ll have a wider choice of aids if you buy them privately. However, ensure
you are not steered towards one or two particular models, as it may be that there are cheaper
models that will suit your needs just as well.
Your hearing aid fitting
Your hearing aids will be chosen according to your level of hearing loss. The audiology staff will
programme them with the computer to suit your needs. They will show you how to put them in,
how to use the controls and how to change the batteries. They should also discuss general care
and maintenance of the hearing aids and give you relevant information to take away with you.
The audiology staff will also explain what your hearing aids can and can’t do. They might suggest
ways for you to get used to them, such as gradually increasing the length of time you wear them.
They may also suggest that you familiarise yourself with wearing the hearing aids by listening to
different sounds around the house before trying them outside, as this will help you to adjust to the
sound of the hearing aids.
You may wish to buy hearing aids privately and see a private dispenser for this. Private companies
are profit-driven and a totally legitimate way to get hearing aids, though do be wary of unrealistic
promises. See ‘What should I consider if I’m buying hearing aids?’ on page 14.
REMEMBER – Hearing aids can’t restore perfect hearing. They make sound louder so that you
can hear it comfortably, but will not necessarily make everything completely clear. Hearing aids
can make a huge difference in everyday life, but any hearing aid dispenser or company that
promises to give you perfect hearing is giving you unrealistic expectations.
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
6
Your follow-up appointment
You should have an appointment about eight to twelve weeks after your hearing aids are fitted, so
you can ask questions and sort out any problems. The audiology staff will check how helpful you
have found your hearing aids in different situations. They may make adjustments to the earmoulds
or hearing aids. Some audiology departments may arrange to do a follow-up interview with you
over the phone, so that you only need to visit again if you need further help or adjustments.
What are the different types of hearing aid?
Hearing aids are described as ‘analogue’ or ‘digital’, depending on the technology they use to
process sound. Digital aids are the latest, most advanced kind and are fitted routinely and as
standard on the NHS. In fact, analogue technology has largely been phased out. However, bodyworn aids and some bone-conduction types are analogue and will continue to be available for use
in exceptional circumstances where they are required. Your audiologist will advise you on the most
suitable type for you.
Digital aids take the signal from their microphone and convert it into ‘bits’ of data – numbers that
can be manipulated by a tiny computer in each hearing aid. This means that the person fitting
your hearing aids can tailor the sound precisely to suit your hearing loss. You may also be able to
switch between different settings suitable for different listening conditions. Many digital aids adjust
themselves automatically to suit different sound environments. See page 8 for more about
hearing aid features.
Behind-the-ear (BTE) digital aids
These have an earmould or a soft tip (for open fittings) that sits inside your ear. The hearing aids
rest behind your ears and a soft plastic tube connects each aid to the earmoulds or soft tips, and
channels sound from the aids into your ears. Most people with NHS hearing aids have this type –
they are sophisticated digital models that can be programmed in a precise way to suit your hearing
loss and everyday needs.
Receiver-in-the-canal (RIC) digital aids
Receiver-in-the-canal (RIC) aids are a new development in hearing aid styles – the speaker
(receiver) is right inside the ear canal, with a thin tube and tip similar to the open fitting. The
amplification of the hearing aid does not need to be pushed through an acoustic tube to get there,
so it’s free of whistling problems. RIC hearing aids typically have a very small part behind the ear
and the aid is very neat and small. It allows open fittings for moderate to severe hearing loss.
In-the-ear (ITE) digital aids
In-the-ear (ITE), in-the-canal (ITC) and completely-in-the-canal (CIC) hearing aids have their
working parts in the earmould, so the whole aid fits into your ear. The smallest CIC aids fit right
inside your ear canal, where they can hardly be seen at all. They tend to need repairing more
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
7
often than behind-the-ear aids and they are also more fiddly, so can be more difficult to use as the
controls are smaller. If you have severe hearing loss, or very narrow ear canals, these aids will
probably not be suitable for you. These types of aid are not usually available on the NHS.
Body-worn analogue hearing aids
Though not widely available anymore, partly because they are so bulky, these have a small box
containing the microphone and working parts. You clip the box to your clothes or put it in your
pocket. The box is connected by a lead to an earphone clipped into your earmould. Body-worn
hearing aids may be more suitable for you if you have visual impairment or find it hard to use very
small switches or buttons. Some models can be very powerful.
Bone conduction hearing aids
These are for people who cannot wear conventional hearing aids due to significant outer and
middle ear problems that can’t be resolved and who therefore have conductive hearing loss.
Conductive hearing loss happens when sound vibrations are unable to pass freely through the
outer and middle parts of your ear. Instead of sound from the hearing aid going into your ear
canal, bone conduction hearing aids send sound vibrations through the skull, directly to your inner
ear. This is done by wearing a headband that holds a small bone vibrator in place behind the ear.
Bone conduction hearing aids tend to use analogue technology.
Another type, called a bone anchored hearing aid (BAHA), involves having an operation behind
your ear to implant a permanent fixture in the bone, which removes the need for wearing a
headband. A small sound processor clips onto this fixture. See our factsheet Bone conduction
hearing aids (available from our helpline – see front page for contact details).
CROS and BiCROS hearing aids
These are for people with hearing in one ear only. CROS (‘contralateral routing of signals’) hearing
aids pick up the sound from the side with no hearing and feed it to your hearing ear. This ensures
that you don’t miss sounds on your deaf side. BiCROS aids are suitable if you have some hearing
loss in your better ear. They amplify sound from both sides and feed it into the ear that has some
hearing.
What are some useful hearing aid features?
The loop setting
A loop system can help hearing aid users hear more clearly in spite of
background noise. You may have seen the sign (see right) indicating a loop
system in shops or banks. You have to turn your hearing aid to the loop setting
to benefit; all hearing aids have this setting, but you may need to get it activated
by your audiologist first.
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
8
A loop system usually consists of an amplifier and a wire cable (loop) that goes around the
listening area/ room and plugs back into the amplifier. The amplifier then plugs into audio
equipment, such as a microphone. The electric current in the loop produces a magnetic field that
sends sound directly to your hearing aids (when on the loop setting), cutting out background noise.
The loop setting used to be called the ‘T’ or ‘telecoil’ setting. You’ll also need to use the loop
setting on your hearing aids to use a telephone with an inductive coupler (similar to a loop
system). For more information, see our factsheet Loops and infrared systems for people with
hearing loss.
Twin or multi-microphones
This describes a directional microphone system found in most hearing aids. It can be switched on
to pick up sounds in front of you, so you can hear them better than sounds to the side or behind
you. This makes it easier for you to focus on what you want to listen to in a noisy place. Many
hearing aids automatically detect where the noise is coming from and adjust the microphone to
reduce it. However, hearing aids cannot know what you want to listen to and so the reduction of
unwanted sound can never be perfect.
Feedback suppression
This automatically reduces the whistling that bothers many people who use hearing aids.
Automatic noise reduction
This reduces some kinds of steady background noise, like the rumble of traffic or the whirr of a
fan.
A choice of listening programmes
Many digital hearing aids allow you to switch between different settings for different listening
conditions. Some adjust automatically in response to different sound environments. During your
hearing assessment or hearing aid fitting, it’s worth mentioning any particular difficulties you may
be experiencing or activities you regularly take part in. A choice of listening programmes may be
helpful in these situations. Your audiologist will discuss these options with you.
Direct Audio Input (DAI) and Bluetooth
Direct audio input (DAI) is a way for a hearing aid to connect directly to other external audio
sources, like CD players, MP3 players, mobile phones or assistive listening devices. Direct audio
input connection can be either through a wire connecting to the ‘shoe’ (a little piece that connects
to the bottom of the hearing aid) or it can be wireless, via FM technology called Bluetooth.
Current hearing aids generally do not stream directly via Bluetooth but use a secondary streaming
device (usually worn around the neck or in a pocket) that connects to the hearing aid, but can only
cover a short distance.
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
9
Bluetooth hearing aid technology can connect to many electronic devices hands-free, including
mobile phones, MP3 players, computers, GPS devices and FM systems. For example, a mobile
phone can ring directly into the hearing aids and you can answer by pushing a button on a small
controller for convenient hands-free communication and sound in both ears (if you wear two
hearing aids), which provides a much clearer signal than when using a phone on one ear.
Bluetooth technology allows coordination between two hearing aids, resulting in improved speech
audibility.
Hearing aids alone may not help in difficult listening situations, such as noisy places or if you are
at some distance from the speaker. This is when assistive listening devices using direct audio
input or Bluetooth can really make a difference. You should discuss assistive listening devices with
your audiologist, so you can choose a technology based on your needs and what you can afford.
What questions should I ask the audiologist?
Whether you choose NHS or private services, don’t be afraid to ask questions, explain your needs,
check your options and ask for more help or explanations if you need them.
 Ask whether an open ear fitting might be suitable for you. This can give a more natural sound
quality if your hearing loss is not severe.
 Find out if you will be able to change the settings to suit different sound environments.
Some hearing aids adapt to different environments automatically.
 Find out if the aids automatically control feedback to stop them from whistling.
 The noise made by the wind blowing across the microphone can sometimes be annoying.
Ask whether the aids have a way of stopping this.
 Find out if the aids can reduce some kinds of background noise automatically, so that listening
is more comfortable.
 Find out if they have directional microphones – this will make it easier for you to hear in noisy
places.
 Find out how easy it is for you to switch the hearing aids on and off and use the controls. Make
sure that you can feel them easily. You may find some models easier to use than others.
 Find out how well the hearing aids work with your home telephone and mobile phone.
If you are consulting a private dispenser, don’t be pressured into buying expensive hearing aids
unless you can try them first to make sure that they are easy to use and really help you. Also,
check that the dispenser offers a trial period in which you can get a refund if you’re not happy with
your hearing aids.
What is loudness recruitment and how can digital hearing aids
help manage the problem?
If you have hearing loss, it’s not uncommon to develop what is known as ‘loudness recruitment’.
Loudness recruitment is an abnormal perception of loudness. Even if you are unable or struggle to
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
10
hear ordinary levels of sound, you may at the same time perceive loud sounds as uncomfortably
loud. This is also described as having a ‘reduced dynamic range of hearing’: dynamic range is the
ability of the ear to deal with quick shifts in loudness.
It may affect people with sensorineural hearing loss, which is caused by damage to the cochlea or
hearing nerve. If you have conductive hearing loss (where sound cannot easily pass through the
outer or middle ear), you will not be affected.
How does loudness recruitment affect hearing aid wearers?
If your hearing aids amplify a louder sound, such as a shout, by the same amount as a softer
sound, such as a whisper, then you will find the louder sounds uncomfortably loud. This means
that you are likely to turn the volume of your hearing aids down, but then will not be able to hear
quiet sounds as well. Fortunately, all digital hearing aids are designed to amplify sound levels in a
way that allows a wide range of sounds to be heard comfortably. It shouldn’t be necessary to keep
adjusting the volume control. In fact, some self-adjusting aids do not have a volume control at all.
How can hearing aids help?
Almost all hearing aids have what is known as automatic gain control (AGC). With AGC, when the
hearing aid picks up soft sounds, it automatically amplifies them more than it amplifies loud ones.
This means you can hear the soft sounds but the loud sounds do not become uncomfortable. Your
hearing aids will do this automatically, but if you experience problems with the volume, your
audiologist will adjust them for you.
If you have sensorineural deafness, you are likely to hear low tones (low-frequency sounds) better
than high tones (high-frequency sounds). You may also tend to have less severe loudness
recruitment with low-frequency sounds than with high frequencies. To allow for this, many modern
digital hearing aids split sound into several frequency ‘bands’ that can be individually manipulated.
It enables you to make the most of your dynamic range of hearing.
How do I service my NHS hearing aids and get new batteries?
With your hearing aids you will be given a booklet that shows the type of hearing aids you have,
and when and where they were issued. You need to keep hold of this as it proves you have
NHS hearing aids, so you can go to the audiology department to get new batteries free of charge
or to check that your aids are working properly.
How to get new batteries
When your aids are fitted, audiology staff will tell you if you can get batteries from the hearing aid
centre by post, at a drop-in clinic or more local centre.
 At a drop-in clinic, you don’t need to book an appointment to get new batteries, or for simple
repairs or earmould retubing. Some audiology clinics don’t have a drop-in clinic, but if you need
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
11
a repair you can arrange an appointment in advance. Your audiologist will tell you when you are
fitted with your hearing aids.
 Some GP surgeries run battery exchange services.
 You can also buy batteries from pharmacies but these can be expensive.
Can I get spare hearing aids?
You won’t usually be able to get spare hearing aids on the NHS, but the policy differs from centre
to centre and depends on several things. For example, you are more likely to get spare hearing
aids if you are registered blind or partially sighted and have very severe hearing loss, or if you
have hearing loss in one ear and no useful hearing in the other.
If you lose or damage your hearing aid, the NHS will replace or repair it. But you might have to pay
a charge if they think you have been careless with it or if it happens more than once. It’s against
the law to sell on your NHS hearing aids. They are NHS property, so if you have aids that you no
longer use, you should take them back to an audiology department.
Remember, if you buy hearing aids privately, you are still entitled to hearing aids on the NHS.
What should I do if my hearing aids aren’t helping?
It’s not uncommon to have a few teething problems while getting used to hearing aids. They can
greatly improve your quality of life, but sadly some people simply stop wearing them because they
find them uncomfortable. The hearing aids get left in the drawer and, of course, they are of no
benefit there. If you are having difficulties with your hearing aids or earmoulds, you can go back to
your clinic for advice. If you think your hearing has changed, you can ask to have it tested again to
see if you need to have your hearing aids reprogrammed or need different hearing aids. You can
also see if we run a Hear to Help service (see page 14) in your area.
N.B. – Many people find adjusting to their hearing aids difficult because of the sound quality. In
some cases it can even take months to get used to the new sound. After years of hearing loss,
you become accustomed to not hearing. The sound enabled by hearing aids can seem artificial
and unnatural at first, but please persevere – you’ll be grateful that you did.
There are some common problems that you may experience with your hearing aids. If you can’t
solve them yourself, your audiologist or will be able to help.
What are the common problems?
Whistling and squeaking
This may be caused by ‘feedback’, which happens when sound amplified by your hearing aids
leaks out and is picked up by the hearing aid microphone.
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
12
It may happen if:
 you haven’t put the earmoulds in properly – push them in gently to check
 you have excess wax in your ears – ask your GP to check your ears
 the earmoulds do not fit your ear snugly enough – ask your audiologist about this
 you have the volume too high (if you are struggling to hear, you may need to have your hearing
retested)
 the earmoulds, plastic hooks or tubing in behind-the-ear (BTE) aids have become loose or split
 the tubing in BTE hearing aids has become hard. If tubing gets very hard, the hearing aids may
not work well. Your audiologist can show you how to change the tubing and will give you spare
tubing. They can also replace the tubing for you.
Buzzing noises
If you hear a buzzing sound, it might mean that you’ve switched your hearing aids to the loop
setting by accident. But if this isn’t the problem, buzzing generally means your hearing aids have
developed a fault and need to be repaired.
If you find it difficult to get used to your hearing aids, don’t give up! Try wearing them for a few
days and make a note of the problems you have. It’s not uncommon for there to be some initial
difficulty, but once you have it right the hearing aids will greatly improve your quality of life.
Make an appointment with the audiology department to talk to the staff about the problems you’re
having. They can check whether your hearing aids are working properly and they may be able to
adjust them to suit you better.
Whatever happens, keep trying. It takes time to get used to wearing hearing aids and to get the
best from them. See ‘Where can I get further support?’ on page 18.
Tips for sorting out common problems
If your hearing aids don’t seem to be working:

Have you turned on the loop setting by accident?

If your hearing aids have volume controls, check that the volume is at the correct level for you
and is not turned right down.

Check that the batteries are the right way round.

Try putting in new batteries.

If you have BTE hearing aids, take them out, pull the soft tubing off the plastic hook of the
hearing aids and blow down the tubing to remove any condensation that may be blocking the
tubing.

Check that the earmoulds are not blocked with wax.

Check that the tubing is not twisted, squashed or split.
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
13
What is Hear to Help?
If you wear NHS hearing aids and find using them a bit overwhelming, our Hear to Help service
might be just what you need. Our Community Support Officers and volunteers may be able to help
you manage and maintain your hearing aids through home visits and drop-in services.
As yet, the service doesn’t cover the whole of the UK, but it’s growing all the time. Contact our
helpline (see front page for details) or visit www.actiononhearingloss.org.uk/heartohelp to find out
if there’s a Hear to Help service in your area.
What should I consider if I’m thinking of buying hearing aids?
It’s important to make sure that you are in control of the decision to buy hearing aids. Be wary of
newspaper advertisements that appear to be from an organisation that is campaigning or providing
information about hearing. These are often from companies who want to sell you hearing aids, and
they can pressure you into spending money on hearing aids that you could get for free on the
NHS. Don’t accept a home visit from a dispenser unless this is what you really want. It’s usually
better, if possible, to visit a fully equipped hearing aid shop or centre. This will help you feel more
in control of the consultation and the room should have the correct sound-proof conditions.
Make sure the private hearing aid dispenser is qualified
By law, anyone offering to test your hearing and sell you hearing aids on the high street must be
qualified, or in supervised training, and registered with the Health and Care Professions Council
(HCPC), which regulates dispensers’ training, skills and conduct, and investigates complaints. See
page 20 for contact details. The HCPC – formerly known as the Health Professions Council (HPC)
– took over regulation of dispensers from the Hearing Aid Council on 1 April 2010.
Qualified hearing aid dispensers have the letters ‘RHAD’ after their name. RHAD stands for
‘Registered Hearing Aid Dispenser’. They may also use other letters after their name, such as
MSHAA, FSHAA, or MRSH – these show their membership of professional organisations. But it is
RHAD that shows they are qualified and registered to dispense hearing aids.
If you can, before you go for your hearing test, try to compare what different dispensers will offer
you and how much they will charge. You can find some helpful information from different
companies on the internet. Be aware that some dispensers will only sell products from one or two
hearing aid companies, while other dispensers will be able to offer a wider range of products.
Don’t be afraid to ask questions, and get all quotations in writing.
How much will my hearing aids cost?
Private digital hearing aids usually cost between £300 and £3,000 each, depending on their style
and how sophisticated they are. You should receive a discount when buying a pair. Many
companies charge extra for the more discreet in-the-ear (ITE) or in-the-canal (ITC) aids.
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
14
Hearing aids last five years or more, but you will have to pay again when they need replacing.
Hearing aids that fit completely in the ear may not last as long. With behind-the-ear aids (BTE),
you may also have to pay for new earmoulds from time to time.
Remember that you’ll also need to budget for a regular supply of batteries and any hearing aid
repairs you need after the warranty expires. Batteries can cost between £25 and £40 a year for
each hearing aid if you wear it all day. Repairs to the hearing aid can cost £100 or more each time.
If you have been diagnosed with hearing loss, you are still entitled to free hearing aids on the NHS
even if you have previously bought hearing aids privately.
How do I choose a private hearing aid dispenser?

Contact our helpline (see the front cover for details). We can give you contact details of private
hearing aids dispensers – though we cannot recommend one over another.

Visit the Locate and Rate section of the Action on Hearing Loss website – it can help you to
find services in your area: www.actiononhearingloss.org.uk/locateandrate

You can check if a hearing aid dispenser is registered with the Health and Care Professions
Council (HCPC) by visiting www.hpcheck.org or calling 0845 300 4472. However, the HCPC
can’t recommend either individual dispensers or particular hearing aids.

If you know someone who has bought hearing aids privately, ask them if they would
recommend their dispenser. But do remember that their hearing loss is unlikely to be the same
as yours, so their hearing aid dispenser may not necessarily be the right one for you.

If you are thinking of buying from a dispenser who is visiting your area, check that you’ll be
able to contact them easily in the future. You’ll need to be able to see them if you have a
problem with your hearing aids and need to get them repaired or adjusted. If in doubt, contact
the HCPC and find out where the dispenser is based, or use a local dispenser instead.

Find out the hours and days of each week when the dispenser will be available to help you. In
some shops or centres the dispenser is there only at certain times.

It might seem cheaper to buy hearing aids abroad, but it may be more expensive in the long
run – see ‘Can I buy hearing aids abroad?’ on page 19.
How do I decide which hearing aids to buy?
Hearing aids are available in a range of styles and with varying features. Not all hearing aids will
suit your hearing loss. Also, those that work well for someone else may not necessarily be right for
you. Very small hearing aids are usually only suitable for mild to moderate hearing loss. They may
not be a good idea if you find it hard to manage fiddly controls, unless you get a remote control.
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
15
The cheapest hearing aids are unlikely to perform well in difficult listening situations (when there’s
lots of background noise) unless you simply want one as a spare aid. However, that doesn’t mean
that you need all the advanced features that more expensive hearing aids may have. It may be
better to have two less expensive hearing aids then one expensive hearing aid with lots of
additional features.
Before you sign any agreement to buy, make sure that you get everything in writing and that you
understand all the terms of the agreement.
I have severe hearing loss – will it be harder to find suitable
hearing aids?
No, not necessarily. There are models specially designed for people with severe and profound
hearing loss. But you will be very reliant on the skill and experience of the dispenser in
programming the aids to give you the best results.
What will happen when I go to a private dispenser?
Once the dispenser has tested your hearing, they will discuss which kind of hearing aids will suit
you. Ask the dispenser to give you information about all the different types of aid that might suit
you, and their prices. Be wary if they don’t give you any choices.
Most people will find a number of benefits from wearing two hearing aids, including:

increased understanding in noisy situations

knowing which direction a sound is coming from

better hearing on both sides.
If you decide to buy hearing aids from the dispenser, the process will be the same as with an NHS
audiologist. They will usually then take an impression of your ear to make the earmould or
measure your ear to fit a soft tip (for an open ear fitting). When this is ready, you’ll need to visit the
dispenser again for them to fit and programme the hearing aids to suit your hearing loss and show
you how to use them.
What should I check before signing the agreement to buy?

Are you getting hearing aids you want at a price you can afford?

What does the price include and what will you need to pay for in the future?

Will you be able to contact and see the dispenser quickly if you have a problem with your aids?

Before you sign anything, make sure you get everything in writing and that you understand all
the terms of the agreement to buy the hearing aids.
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
16
Can I get my money back if I’m not happy?
Dispensers should give you at least a 28-day trial period with a money-back guarantee so that you
can return the hearing aids if you aren’t happy with them. If the dispenser isn’t prepared to offer
this or suggests a guarantee for repair only, instead of giving you the option of a refund, go
somewhere else. You are unlikely to get a full refund because the price you pay usually includes
the hearing tests and fitting. Some companies charge a 12.5% cancellation fee, so check the small
print and returns policy carefully before buying.
How long are my hearing aids guaranteed for?
You’ll have to pay for repairs after the guarantee on the hearing aids runs out. The cost of these
can mount up. Guarantee (‘warranty’) periods are often two years but can range between one and
four years, so find out what the guarantee period is for the hearing aids you are being offered. You
can usually insure your hearing aids against loss or damage through your household insurance.
It’s a good idea to check this with your household insurance company first before you buy the
hearing aids.
What should I do if I have a problem with the hearing aids I’ve
bought?
Most people are happy with the hearing aids they buy and with the service they get from their
private hearing aid dispenser, but some people run into difficulties because:

the aids do not help them to hear as well or understand speech as clearly as they had hoped or
were led to believe

the dispenser pressurised them to buy hearing aids

the hearing aids give repeated trouble – for example, they may whistle or be uncomfortable –
and the dispenser cannot put this right.
If you have any problems with hearing aids you have bought, the first thing you should do is ask
your dispenser for help and advice. Make a note of the problems you experience over a period of
a few days so that you can explain what is wrong and help the dispenser to sort it out. It’s very
important that you are aware of the trial period and try to resolve any problems in this time so you
can ask for a refund if you need to.
If you are still unhappy with your hearing aids, or feel the dispenser is not providing a good and
professional service, contact the ‘Fitness to practice’ department at the Health and Care
Professions Council (HCPC) (see page 20 for contact details.) Describe the problems you have
had with the hearing aid dispenser, include copies of any correspondence or other documents
connected with the sale and the contact details of the dispenser or company that sold you the
hearing aids.
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
17
If the HCPC decides a dispenser has broken any of its rules, it can caution or suspend them from
the register. In extreme cases, a dispenser may be struck off the HCPC’s register and will be
unable to continue to sell hearing aids. If you still aren’t happy with the outcome, and feel the
HCPC has not addressed your concerns, you could pursue a claim through the Small Claims
Track. Your local Citizen’s Advice Bureau can advise you about this.
What if I want to make a complaint about an NHS audiology
department?
If you’re not happy with the service you’ve had from an NHS audiology department, and would like
to complain, your first step is to speak to the hearing aid service manager. It may be possible to
sort the problem out quickly. If you’re still not happy that your complaint has been dealt with
properly, ask about the NHS Trust complaints procedure.
Where can I get further support?
Just acknowledging that you have hearing loss and may need hearing aids is a huge step, but
there is plenty of support available.

Your audiology department is there to help you if you have problems with your hearing aids.
Some audiology departments also have a hearing therapist who can help you get used to
your hearing loss and hearing aids. The hearing therapist can liaise with social services if you
need other equipment. The department may run tinnitus clinics and have information on local
support groups you can join.

Social services – Ask the sensory impairment unit or a social worker with deaf people to visit
you to assess your needs. See our factsheet Social services for adults who are deaf for more
information.

Make sure your family and friends know about your hearing loss, so they can support you.
Our leaflet Learning to lipread and our communication tips card (available from our helpline –
see front page for contact details) can give them useful information. Keep reminding them that
they must make an effort to talk clearly to you. You are not being selfish or demanding – no
one wants to be left out of a conversation.

Lipreading classes – You’ll be able to learn tips for lipreading and to practise with other
people with hearing loss, informally; they can also act as a support group.

Find out if there is a local hard of hearing or deaf group you can join. Sharing experiences
and listening to other people’s suggestions can be very helpful. You can contact our free
helpline (see front page for contact details), which can direct you to a group in your area.

Volunteer visiting services – Find out if there is a service for people with hearing loss in your
area, such as our Hear to Help service. Support from other people can encourage you to keep
trying with your hearing aids.

Equipment – Our Solutions catalogue is packed with different products and gadgets that may
be useful to you in the home, such as personal listeners, tinnitus relaxers, flashing doorbells
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
18
and vibrating alarm clocks. For a free copy, email [email protected] or call 01733
361199 (tel) or 01733 238020 (textphone).
Can I buy hearing aids abroad?
You may have read about cheaper hearing aids for sale abroad, particularly in Germany and
Denmark. We can’t recommend any particular hearing aid models, manufacturers or services.
We would advise you to think carefully before buying hearing aids abroad.
The initial cost of buying hearing aids abroad may be lower than in the UK, but you might need to
see the dispenser for adjustments – sometimes several times – which could be expensive and
inconvenient.
It’s important to check before you buy what will happen if you need more help or if your hearing
aids break down once you are back home. Hearing aid dispensers in the UK may offer to service
your hearing aids, but be aware that some use this as an opportunity to pressure you into buying
their hearing aids.
Where can I get further information?
Action on Hearing Loss
Contact our helpline for information and support.
Telephone 0808 808 0123
Textphone 0808 808 9000
[email protected]
To order our Solutions catalogue:
Telephone 01733 361 199
Textphone 01733 238 020
[email protected]
National Deaf Children’s Society (NDCS)
NDCS supports deaf children, young people and their families to overcome the challenges
of childhood deafness.
15 Dufferin Street, London EC1Y 8PD
Tel/textphone 0808 800 8880
Fax 020 7251 5020
[email protected]
www.ndcs.org.uk
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
19
Health and Care Professions Council (HCPC)
Park House, 184 Kennington Park Road, London, SE11 4BU
Telephone 020 7840 9801
Fax 020 7820 9684
www.hpc-uk.org
Fitness to practise department
Telephone 0800 328 4218
Fax 020 7582 4874
[email protected]
Visit www.hpcheck.org or call 0845 3004 472 to find out if your hearing aid dispenser is registered.
Action on Hearing Loss Information, December 2012
The Royal National Institute for Deaf People. Registered Office: 19-23 Featherstone Street, London EC1Y 8SL.
A company limited by guarantee registered in England and Wales No. 454169, Registered Charity Numbers 207720 (England and Wales) and
SC038926 (Scotland).
Everything you need to know about getting hearing aids Action on Hearing Loss Information, December 2012, v1.1
20