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One of the problems facing health services is that of communicating effectively essential information concerning their services and care plans with deaf people.

Planners and providers of health services including audiology services need to recognise their responsibilities and the rights of deaf people to have full information and access to services available to the community as a whole.

Under the Disability Discrimination Act 1995 (DDA), it is unlawful for a service provider to discriminate by offering a lower standard of service or providing a service in a worse manner to deaf people.

It is estimated that one in five of the population has a hearing loss; this means that there are over one million people in Scotland who have a range of hearing loss, from the profoundly deaf to those who are mildly deaf.

Hearing loss is invisible and therefore often misunderstood. But it can be totally undermining, especially in old age when it isolates people and can destroy independence and well-being. (Audiology in Crisis: Still waiting to hear, RNID, March 2001)

Hence, the audiology services are of great importance in helping to meet the needs of deaf people of all ages.

The Scottish Council on Deafness therefore recommends that the following good practice be implemented:

1. In general, people over the age of 50 years should have hearing tests at regular intervals.
   
   
2. Deaf school-leavers should continue to receive hearing tests at regular intervals.
   
   
3. Deaf people should have the right, if they wish, to have the most appropriate and up-to-date hearing aids (including digital & other advanced hearing aids) which meet their individual needs.
   
   
4. Unless contra-indicated, hearing aids should be fitted in both ears.
   
   
5. People with hearing aids should receive regular follow-up checks on their hearing aids to ensure they are continuing to function correctly.
   
   
6. Where necessary, people recently diagnosed with hearing loss should have access to appropriate rehabilitation such as counselling, etc.
   
   
7. Audiology Services should be able, where necessary, to inform people with hearing loss about appropriate local support services such as lip-reading classes, communication support services, suppliers of assistive devices, etc.
   
   
8. All staff in Audiology Services should receive deaf and deafblind awareness training; this should be provided both in pre-service training, and in in-service training on an ongoing basis.
   
   
9. All staff in Audiology Services should have basic skills in communication with deaf people and awareness of communication support services; this is particularly important for deaf parents/adults and children.
   
   
10. All staff in Audiology Services should have an understanding of Deaf culture and the different, including non-audiological models of d/Deafness.
    
    
11. Information material should be developed in appropriate languages (e.g. British Sign Language or plain English) and with illustration, taking into account the culture, identity and language of deaf people.
    
    
12. Support should be given to Audiology services to ensure that the waiting times for hearing tests and for the fitting of hearing aids are reduced.
    
    
13. Audiology Services should follow the Good Practice Guidance for Adult Hearing Aid Fittings and Services issued by the Scottish Executive Health Department [NHS HDL (2001) 19].
    
    
14. The Audiology Services should give consideration to improving the accessibility of their services to deaf people, particularly with regard to telecommunication for making appointments, enquiries, etc. and vice versa.
    
    
15. Health service personnel should be informed about the Disability Discrimination Act and other relevant legislation.
    
    
16. The Audiology Services should consider the needs of deaf people who are outpatients, e.g. in the waiting areas, (loop systems, tannoy systems, etc).
    
    
17. Appropriate Primary Care staff, including General Practitioners, should be encouraged to refer patients with suspected hearing problems to the Audiology Services.
    
    
18. All staff in the Audiology Services should also be fully aware of the Scottish Council on Deafness' position statements on health services, Universal Newborn Hearing Screening and Cochlear Implants all of which should be read in conjunction with this document.
    

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Selected Bibliography

Audiology in Crisis: Still waiting to hear, RNID, March 2001.

Good Practice Guidance for Adult Hearing Aid Fitting and Services (NHS HDL (2001) 19), Scottish Executive Health Department, March 2001.

Quality Standards in Paediatric Audiology: Volume 1, NDCS, 1994.

Quality Standards in Paediatric Audiology: Volume 2, NDCS, 1996.

Quality Standards in Paediatric Audiology: Volume 4: Guidelines for the early identification and the audiology management of children with hearing loss, NDCS, 2000.

Waiting to Hear: a Report on waiting times for hearing tests. RNID, May 1999.

King, Angela & Reynolds, Margaret, Audiology in Scotland: An RNID Research Report, RNID, February 2002.