New year, new impetus for expanding community audiology services

Audiology services are seeing the usual seasonal spike in demand for hearing tests with appointment searches and bookings climbing after the Christmas break.

Families will have spent more time together sharing activities where hearing loss in parents and grandparents may have become more apparent. This often presents in someone needing the TV volume turned up louder than usual or older members of the family struggling to hear or join in with group conversations.

The increase in the number of people acknowledging they have a hearing loss and seeking support is the first positive step on their journey to improved quality of life, but in some areas of the UK patients will wait longer than others to get the help they need.

Danny Beales MP for Uxbridge and South Ruislip – and member of the Health and Social Care Select Committee – tabled a timely Commons debate at the end of December highlighting the urgent need to address hearing loss as a serious health issue, not a minor inconvenience. He proposed a new model of community audiology services which would be ‘better for patients, better for taxpayers, better for the economy.’

His opening speech outlined the impact of hearing loss which affects millions across England and has profound implications for physical health, mental wellbeing, independence, and economic productivity:

Health and wellbeing: Untreated hearing loss increases risks of mental ill health (2.5x), falls in elderly (2.4x), and is a major modifiable risk factor for dementia (early treatment can reduce dementia incidence by 7%).
Economic cost: Estimated £25 billion annual loss in productivity; individuals earn £2,000 less per year on average, with 40% retiring early due to communication challenges.
Demand for services: Incidence rises sharply with age with 50% of people experiencing hearing loss by age 50, and 80% by age 80, creating significant pressure on NHS services as the population ages.

Proposing reform through a community-based audiology model, Mr Beales outlined five reasons for shifting audiology services from hospital to community settings:

Clinical Efficiency: Low-risk procedures can be managed outside hospitals, reducing ENT waiting times.
Cost Savings: Community pathways are 15–25% cheaper than hospital-based services.
Preventive Care: Easier access encourages early intervention, reducing risks of dementia, falls, and mental health issues.
Improved Patient Experience: Self-referral options can reduce travel time and improve access to care for older adults.

Mr Beales also unpacked some of the challenges that hinder service reform including the current fragmented system and a lack of national oversight – there is currently no national audiology lead within DHSC creating an absence of clear accountability.

Adding further context, he highlighted that only 30 of England’s 42 ICBs commission adult community audiology services, and many only offer partial coverage. In addition, local tariff setting for NHS audiology contracts has led to wide variation in quality and value for money, with some tariffs falling below delivery costs, forcing providers to cut essential services like follow-up care and rehabilitation.

Other notable contributions to the debate came from former GP Dr Luke Evans, MP for Hinkley and Bosworth, who said: “…when people think about care delivered close to home, hearing loss services are among some of the most visible examples on the high street and in our community settings across the country. I visited the Specsavers on Hinckley’s high street, as well as the pharmacy in Newbold Verdon, only a couple of months ago to see what they provide.

“There is a real opportunity to bring care towards people, which makes high streets a good bellwether for this Government’s ambition on prevention and community care and how that is being translated into practice.”

The Minister for Care, Stephen Kinnock MP responded to Dr Evans saying: “He raised an important point about self-referral, which of course depends on local commissioning arrangements. There is inequality and unwarranted variation in the ability to self-refer. We want more self-referral. We think there are opportunities in upgrading the functionality of the NHS app. Our objective is absolutely to be able to do this without having to go through a GP. There are some technology-related solutions, but I want to assure him that there is no conscious decision from the Government to deprioritise self-referral; I just think that there are some variations.

“The old chestnut that we are constantly trying to crack is around devolving to ICBs the power and agency that they should have because they are closest to the health needs of their population, while ensuring that they are clear about the outcomes, frameworks and standards that we expect. We honestly hold our hands up and say that we have not got that right in all cases, but we are committed to self-referral as a principle and as a really important part of the shift from hospital to community.”

In closing, Mr Beales called for a national commissioning framework to standardise tariffs, mandate quality assurance, reinstate waiting time reporting, and set a clear direction for community-based audiology.

He urged for sustained investment in workforce development and equitable access to core interventions like earwax removal. He acknowledged that a community-based audiology model offers a practical, evidence-based opportunity to improve access, quality, and value for money, but that achieving this would require national leadership, clear standards, and long-term investment.

The Access to Care Report, published September 2025, includes more information on the benefits of community eye and hearing services and bringing care close to home.