Abstract
Introduction: People with deafness or hearing loss (PDHL) face substantial communication barriers within the UK’s National Health Service (NHS), leading to reduced access to care, lower engagement with services, and poorer health outcomes. Deafness can affect anyone, but acquired hearing loss increases in prevalence and severity with age. A multidisciplinary working group comprising patients, clinicians, researchers, and charity representatives was formed to explore accessibility, communication practices, and deaf awareness across NHS services.
Method: A cross-sectional survey assessed the communication experiences of PDHL using NHS services, and the perceived impact on well-being. The survey incorporated rating scales and open-ended questions and was available in British Sign Language (BSL). Responses were analysed using descriptive statistics and thematic analysis.
Results: A total of 556 individuals completed the survey, including 50 family members or carers who had supported PDHL at NHS appointments. All participants had used NHS services in the past 24 months, with 10% identifying BSL as their preferred language. Thematic analysis of qualitative responses identified three main issues: (1) persistent accessibility challenges; (2) significant communication breakdowns across the patient journey; and (3) a lack of consistent, effective deaf-aware communication. Notably, 64.4% of PDHL respondents reported missing at least half of the important information shared during NHS appointments. Six key recommendations for change were established, including appropriate infrastructure to support accessible services, mandatory deaf awareness training for all healthcare professionals, and collaboration with PDHL.
Conclusion: This is the most extensive UK-based survey exploring deaf patients’ experiences in the NHS to date, highlighting ongoing breaches of the Accessible Information Standards (AIS) and serious risks posed by poor communication. In response, the working group have developed British Society of Audiology Practice guidance on deaf awareness in healthcare settings. Future work will generate practical tools and resources to help achieve AIS compliance across NHS settings.
Comments
Improving Deaf Awareness and Accessibility in NHS Services
This important study exposes persistent barriers faced by people with deafness or hearing loss when accessing NHS care. The findings highlight widespread breaches of accessibility standards and the urgent need for mandatory deaf awareness training. Embedding inclusive communication practices will enhance patient safety, equity, and person-centred care across healthcare settings.
Response
Thank you for your comment.
Really meaningful work!…
Really meaningful work! Would be interesting to re-survey some time following the implementation of the Guiding Principles and training to improve NHS deaf awareness, to see what the impact is on deaf patients' experiences within the NHS. Is the ultimate aim to have the training/resources in development available nationwide?
Response
Thank you. A re-survey after implementation of guidance would be a great way to measure impact.
We are starting with audiology and ENT services first, but yes - the ultimate aim would be to have training/resources available nationwide for application to all healthcare settings.
Best wishes,
Helen.
Medical education and Deaf awareness.
A really insightful study addressing an important issue. As a final-year medical student, I’ve encountered many patients with hearing loss, particularly among older adults, yet I have received very little formal training on effective communication or on the Accessible Information Standards mentioned in your poster. There seems to be a mismatch between how common hearing loss is and how little it features in medical education. I would be interested to hear your thoughts on which aspects of deaf awareness and the AIS would be most useful to integrate into undergraduate and early postgraduate curricula.
Response
A valuable comment - and something we are beginning to think deeply about - In an ideal world, all aspects would be covered. The principles of deaf awareness and the AIS are straightforward, and good communication benefits all individuals, not only those with reduced hearing levels.