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EARS, NOSE & THROAT
Full campaign on www.healthawareness.co.uk
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WHO estimates that globally one in five people live with hearing loss and unaddressed hearing loss costs governments $980 billion annually. Sue Archbold, Patron of National Association of Deafened People (NADP), Member of Who Working Group Lidia Best, Chair of the National Association of Deafened People (NADP), Member of Who Working Group
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The most vulnerable are in danger of being forgotten. Taran Tatla, Honorary Secretary, ENT UK
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Good hearing is important at all stages of life, but it is often taken for granted. Professor Dr Astrid van Wieringen, Dept Neurosciences, KU Leuven (Belgium)
Q1 / 2021
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IN THIS ISSUE
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Ensuring hearing care for all Every year on 3rd March, the world celebrates World Hearing Day, led by the team at World Health Organization (WHO). This year sees the launch of the World Report on Hearing.
World Hearing Day is an invaluable opportunity to raise awareness.
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Taran Tatla, Honorary Secretary, ENT UK
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The pandemic made tinnitus worse for 46% of people in the UK.
WRITTEN BY
Sue Archbold Patron of National Association of Deafened People (NADP), Member of WHO Working Group
David Stockdale, Chief Executive, British Tinnitus Association
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Tinnitus has also been identified as a symptom of long-COVID, raising the number of people experiencing the condition and requiring support. Nic Wray, Communications Manager, British Tinnitus Association
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WRITTEN BY
Lidia Best Chair 0f the National Association of Deafened People (NADP), Member of WHO Working Group
he interest at WHO in ear and hearing care has developed rapidly over recent years with the appointment of Dr Shelly Chadha as Technical Officer for Prevention of Deafness and Hearing Loss. Her great work led to the World Resolution World Health Assembly 70.13 in 2017. All member states were asked to integrate strategies for ear and hearing care within the framework of their primary health care systems. To support the implementation of the Resolution, WHO created the World Hearing Forum, a global network of stakeholders. Impact of hearing care on society WHO estimates that globally one in five people live with hearing loss and unaddressed hearing loss costs governments $980 billion annually. They also recognise the cost of unaddressed hearing to society – the theme of World Hearing Day 2017 was A Sound Investment: investing in managing hearing care changes lives and saves society money. The inaugural meeting of the World Hearing Forum in Geneva in December 2019 hosted a group of 198 participants from throughout the world to focus on a number of these key areas. In light of the pandemic, the Forum now meets online with excellent webinars – many who would not have the opportunity of attending at Geneva can now participate fully and share the work of leading experts in the field of hearing care.
WHO estimates that globally one in five people live with hearing loss and unaddressed hearing loss costs governments $980 billion annually. Hearing care for all This year, the theme of World Hearing Day is Hearing Care for ALL: Screen, Rehabilitate, Communicate with the launch of the first ever World Report on Hearing. The global events of the day will be recorded over 24 hours on the Hear-a-thon 2021 Facebook page (#hearathon). The Report provides the most up to date evidence on ear and hearing care and is an invaluable tool for change for those endeavouring to improve services. It makes clear that the number of people living with unaddressed hearing loss and ear diseases is unacceptable. Investing in hearing care benefits people with hearing loss and brings financial gains to society. The World Report on Hearing’s recommendations set an important global agenda to bring ear and hearing care to the forefront of policymakers, public health officials and governments. This is a real opportunity to make it known that access to timely and appropriate hearing care is essential for people with hearing loss, enabling them to achieve their full potential.
Scan the QR code to access the report
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Patients at the cutting-edge of hearing loss developments If you have lived experience of a condition, your opinion and advice is going to be crucial to researchers, say two patients involved in new hearing loss studies.
T INTERVIEW WITH
Jean Straus Patient
INTERVIEW WITH
Michael Prior Patient
Written by: Tony Greenway
Across the three BRCs, there are opportunities to get involved in research and to participate in a wide range of studies on topics related to hearing loss and hearing-related conditions so please email: BRChearing-research@ ucl.ac.uk Hearing-research@ nottingham.ac.uk hearingresearch@ manchester.ac.uk
he National Institute work closely with people who have for Health Research lived experience of hearing loss (NIHR) Biomedical and related conditions like tinnitus Research Centres (BRCs) and hyperacusis, at all stages of the at University College research process...getting involved London Hospitals, can also mean helping to decide what Manchester, and the University research questions we should be asking of Nottingham conduct cutting and being a key part of the team that edge research in to hearing loss designs and carries out the research.” and tinnitus. They collaborate with people with lived experience Using data to improve treatments and of hearing loss and tinnitus to develop new solutions coproduce their research. The NIHR BRCs at UCLH, Manchester Jean Straus lost her hearing without and Nottingham are co-leading warning- known as idiopathic sudden the NIHR Hearing Health - Health sensorineural hearing loss. “There’s a Informatics Collaborative (HIC) to temptation to withdraw from life,” she harness data from hearing services admits. “But I try not to give in to it.” across NHS sites. Unfortunately, things have been Both Jean and Michael insist that made worse by COVID-19. “When I talk using routinely collected health data to someone who’s wearing a mask, I for research is crucial to improve can’t see their lips moving,” says Jean. treatments for those with hearing “I turn from an articulate woman into issues. “Data is a rich resource,” says a person who is dependent Michael. “In my view, it’s important on their willingness to adapt how they that the medical establishment gets communicate buy-in from the with me.” patient community However, Jean has to use their found a new sense health data in of empowerment order to advance I became interested in by taking part in helping researchers because research and make hearing loss studies. breakthroughs.” I have hearing loss and “When you lose your Mr Nish Mehta, tinnitus, but also because hearing, you feel consultant ENT helpless,” she says. surgeon who leads I wanted to put something “But collaborating hearing health back into healthcare. I’ve with the BRCs to data research at gained a lot and would co-produce research the NIHR UCLH recommend it to anyone. has helped me feel BRC, says “by more in control. It’s anonymising and mentally stimulating, wonderful to combining the information across be at the cutting-edge of hearing loss hearing health providers we plan developments and to have your voice to develop a better understanding heard by researchers whom I respect.” of how hearing loss, and its current Michael Prior agrees. He has suffered treatments, affect our population. from late-effect hearing loss and We hope to develop new methods tinnitus as a result of the cancer of identifying underlying causes of treatment he had in the early 1980s. hearing loss, giving us the ability to Michael now works closely with the offer targeted trial participation for NIHR BRCs, including research into the most appropriate patients.” the late-effects of platinum-based chemotherapy. Working together for patient benefit “People such as Jean and I have lived The three BRCs regularly join forces experience of this condition,” he says. to maximise the ability of their “That’s why our opinion is so valuable. research to help patients with hearing I became interested in helping loss and tinnitus - recently securing researchers because I have hearing loss NIHR funding for the FAMOUS trial and tinnitus, but also because I wanted looking at hearing aid use. Professor to put something back into healthcare. Kevin Munro, NIHR Manchester BRC I’ve gained a lot and would recommend Hearing Health Lead says: “The scale it to anyone.” and scope of FAMOUS is unparalleled in UK audiology and would probably A variety of ways to be involved not have been possible without the Dr Padraig Kitterick, hearing theme collaboration of all the leading hearing lead at the NIHR Nottingham BRC research groups.” says “It is vitally important that we
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Shouting out for better communication and education in dysphagia In health, eating and drinking play an important role for physical, social and mental well-being.
Dysphagia affects all ages Swallowing disturbance is common, conservative estimates suggest 8% of the world population and almost 100 million in the developed world are impacted. All ages can be affected, although it appears more commonly at the extremes of age. Later age-related swallowing difficulty is increasingly recognised with an ageing UK population, difficulties compounded when conditions such as Alzheimer’s and Parkinson’s co-exist. Symptoms are managed by multiple healthcare professionals in specialist, community and nursing home settings. Primary presentation may be through onset of seemingly unrelated symptoms, including voice change, coughing or choking. Systematic enquiry, examination and investigations require coordinated expertise crossing traditional in-hospital and community care boundaries. Better education for all During COVID-19, usual patterns for healthcare working and service delivery have been disturbed. Patients at extremes of age, already highly vulnerable for dysphagia, have been impacted in even greater measure through delays in referral, investigation and treatment pathways. Better public and health professional education is critically needed. In later years, dysphagia may be fixed simply through provision of well-fitted dentures, or assisting loved ones with shopping, cooking and feeding at mealtimes. For more complicated scenarios, recognition of the “at risk” individual, when, how and who to call upon for help and prompt support is key; the development of integrated care pathways for dysphagia hold much promise. World Voice Day highlights the need for greater public and professional awareness of dysphagia, and its impact on quality of life.
WRITTEN BY
Taran Tatla Honorary Secretary, ENT UK
©Yuliya Baranych
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efinitions of dysphagia vary, making it difficult to quantify its prevalence and incidence or illustrate its impact on society. At an elemental level, it is swallowing difficulty for liquids, solids or both. It can be short-lived, intermittent or progressive in nature. In severe cases, malnutrition and weight loss may raise alarm, particularly through worry of cancer. However, more commonly it links with other factors such as taste or appetite disturbance, cognitive disturbance and food allergies (known or unknown). Anxiety and stress frequently link with swallowing difficulty, highlighting a complex and intricate link between mental and gut health.
Better communication and education are needed for ENT World Hearing day highlights the need for greater awareness by public and healthcare professionals of ENT conditions and their impact on quality of life.
E WRITTEN BY
Taran Tatla Honorary Secretary, ENT UK
NT conditions are very common, covering everyone from newborns to the elderly. Symptoms are managed by healthcare professionals in community and specialist settings, but even more frequently by parents and patients themselves. Seeking advice from a healthcare professional Many sufferers will try home-made or over-the-counter remedies before contacting a professional. Some may have sound scientific basis, but others less so. Using cotton bud sticks to “clean” out ear wax, causing further hearing loss through wax impaction or ear infection, highlights a need for better public education. Good ENT health starts with avoiding self-harm and balancing appropriate lifestyles, diet and actions. ENT symptoms are commonly caused by environmental and dietary allergens and other seemingly innocuous triggers impacting the sensitive organ linings. Tinnitus often accompanies hearing loss and imbalance predisposes to risk of falls. New factors affecting senses While exposure to loud noise was once primarily occupational through machinery, today it is often selfinflicted via loud music played through headphones. Tinnitus, hearing loss and deranged balance account for significant mental health and cognitive disturbance, research clearly linking with anxiety, depression, stress and even dementia. Quality of life is reduced by such sensory disturbances.
ENT symptoms are commonly caused by environmental and dietary allergens and other seemingly innocuous triggers. The effect of respiratory viruses such as COVID-19 on the senses of smell and taste has been highlighted recently in the media. The secondary sensory impact upon the ear organs however is not appreciated by the public or healthcare professionals. Doctor-patient communication has been impeded, face-to-face meetings replaced by virtual encounters. The most vulnerable – those with hearing and voice loss, communication issues at extremes of life, mental health, brain injury or language deficiency – are in danger of being forgotten, as we harvest technology to facilitate communication and knowledge sharing through telemedicine and tele-training. Providing better education for ENT As well as ensuring ENT professionals are fully equipped to understand and meet these challenges, it is important that the public receives the best possible education in maintaining ENT health. World Hearing Day is an invaluable opportunity to raise awareness and help us all to ensure we have the information we need to properly look after ourselves.
ENT UK provide unique educational content online through its BACO Educational Package. The latest ENT innovations and cutting-edge research are accessible to healthcare professionals managing ENT conditions around the world. Other public focused, UK grass-root initiatives coinciding with World Hearing Day include “hearing bird-song”.
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Providing support for the millions who find it hard to swallow
manoeuvres, strategies and protocols to improve function. “For example, in the case of stroke patients, treatments aim to achieve neuroplasticity (rewiring parts of the brain that manage swallowing),” she explains. Making drinks thicker There are a number of options which can be used to assist patients swallowing, one of these is adding thickeners to food and drinks. Sandra says: “Thickeners are a useful tool as part of rehabilitation. They can improve swallow safety for people with dysphagia enabling them to enjoy tea, coffee or squash rather than being ‘nil by mouth’. Thickeners are no longer just starch based. Advancements to the more recent gum-based thickeners ensures the same level of consistency in the cup as well as the mouth. Gumbased thickeners are also clear and tasteless.” IDDSI stands for International Dysphagia Diet Standardisation Initiative. All over the world, people with dysphagia are recommended modified food and drink using IDDSI. “Speech therapists are supported by thickener manufacturers to provide nurses and carers with excellent training in the correct use of thickening products” she says.
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Difficulty in swallowing is a widespread health problem. In fact, dysphagia affects 590 million worldwide.
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he term dysphagia derives from the Greek; dys - meaning ‘difficult’ and phagia meaning ‘to eat’. Dysphagia is a serious condition that can be experienced by people who’ve had a stroke, head and neck cancer, progressive neurodegenerative diseases such as Parkinson’s Disease, acute brain injury, dementia, cerebral palsy or adult learning disabilities amongst others. More than 50% of aged and frail nursing home residents may have dysphagia. It can occur at any time of life from premature babies to centenarians. Even animals can experience the condition.
There are a number of options which can be used to assist patients swallowing, one of these is adding thickeners to food and drinks.
Devoted to helping Speech and Language Therapist, Sandra Robinson, based in Worcestershire, has devoted her career to helping dysphagia patients throughout the UK. She explains: “Dysphagia is a difficulty or inability to move food, drink or tablets effectively and safely from the mouth, through the oesophagus to the stomach and, some say, involves the whole digestive tract. Assessment and treatment “It’s a condition that occurs due to other illnesses. Proper assessment of patients is essential before implementing the next steps.” Speech therapists assess patients in a bedside evaluation and also via instrumental assessments, which reveal the nature of the swallowing difficulty. The Royal College of Speech and Language Therapists (RCSLT) and the Health and Care Professions Council (HCPC) ensure that speech therapists are adequately trained and competent to work with children or adults with dysphagia. They provide a variety of options including exercises, sensory work,
INTERVIEW WITH
Sandra Robinson, HCPCReg, MRCSLT Independent Speech and Language Therapist
WRITTEN BY
Diane Priestly
Then there’s the social-psychological impact of not being able to eat and drink normally. Dysphagia can really affect the person’s quality of life. The condition can cause long term ill-health From her years of experience working for the NHS in acute and community settings and then in private practice, Sandra knows that treating dysphagia is vitally important because left untreated the condition can be fatal. “The consequences of untreated or inadequately treated dysphagia can lead to significant ill health and complications as well as death through choking, aspiration pneumonia, chest infections, malnutrition and dehydration.” Improving quality of life “Then there’s the social-psychological impact of not being able to eat and drink normally. Dysphagia can really affect the person’s quality of life. “In hospitals and nursing homes, giving food and drink to a relative is often the one caring act left for family members to show their love. It’s important we make this possible in every way we can.” Read more at nestlehealth science.co.uk
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Improving care to tackle tinnitus timebomb Tinnitus can have a significant impact on a patient’s quality of life. New research is vital to helping find new solutions to treat the condition.
T WRITTEN BY
David Stockdale Chief Executive, British Tinnitus Association
innitus – the sensation of hearing sounds with no external source – can be very distressing to live with. An estimated one in eight adults experience persistent tinnitus. There is no cure, and many people find existing treatments and services unsatisfactory. Why is there no cure? A recent paper1 identified a series of obstacles in developing a cure for tinnitus, including a lack of foundational knowledge of tinnitus and its causes. It also highlighted a significant lack of funding and research capacity.
WRITTEN BY
Nic Wray Communications Manager, British Tinnitus Association
In 2020 we were able to invest in two important projects looking to improve our understanding of tinnitus. However, we could not fund all submitted proposals. Change is urgently needed. Our Tinnitus Manifesto makes three calls the Government must take to give people with tinnitus hope for a cure: • Increase funding for tinnitus research to 1% of the budget for treating tinnitus - an investment of £7.5m per year. • Build long-term infrastructure to ensure the capacity to deliver real progress. • Prioritise studies that will help establish the key foundational knowledge for tinnitus so researchers can move forward to find cures. Despite current challenges, we are continuing to demand progress. The effect of COVID-19 It quickly became apparent that tinnitus was entwined with the COVID-19 pandemic. Results from an international study,2 supported by the BTA, found that lifestyle changes during the pandemic made tinnitus
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Giving hope for a cure
worse for 46% of people in the UK, and that four in 10 people who had experienced COVID-19 symptoms found their tinnitus more bothersome. Tinnitus has also been identified as a symptom of long COVID,3 raising the number of people experiencing the condition and requiring support. A tinnitus timebomb? The climb in cases and increased distress people are experiencing reinforces the findings of our new report, This Is My Silence, which exposes the mental health challenges of living with tinnitus. One in six people (16%) with tinnitus have had suicidal thoughts because of their condition, 71% report having anxiety, and nearly half (45%) experience depression. The study showed that specialist support is nearly twice as likely to reduce feelings of stress around tinnitus than a GP appointment. However, there is a perilous lack of capacity in secondary tinnitus services. The NHS needs improved training for
Lifestyle changes during the pandemic made tinnitus worse for 46% of people in the UK. GPs and high-quality secondary care for people with tinnitus alongside a new standardised treatment model if it is to avoid a “tinnitus timebomb”. The mental health and quality of life impacts of tinnitus are just too great to ignore. References 1. McFerran DJ, Stockdale D, Holme R, Large CH, Baguley DM. Why is there no cure for tinnitus? (2019) Frontiers in Neuroscience. https://doi.org/10.3389/fnins.2019.00802 2. Beukes EW, Baguley DM, Jacquemin L, Lourenco MPCG, Allen PM, Onozuka J, Stockdale D, Kaldo V, Andersson G and Manchaiah V (2020). Changes in tinnitus experiences during the Covid-19 pandemic. Frontiers in Public Health doi: 10.3389/fpubh.2020.592878 3. National Institute for Health and Care Excellence (2020) COVID-19 rapid guideline: managing the long-term effects of COVID-19. [online] nice.org.uk/guidance/ng188
British Tinnitus Association 0800 018 0527 tinnitus.org.uk
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The future of hearing care is person-centred In the first ever World Report on Hearing, the World Health Organization is urging policy makers to integrate person-centred ear and hearing care into national health plans.
F WRITTEN BY
Lise Lotte Bundesen Managing Director, Ida Institute
Paid for by Ida Institute
or anyone who wants to see hearing care that is designed around the individual and that enables people to be equal and active partners in the management of their hearing loss, the World Report on Hearing is a welcome development. It exemplifies a growing trend, that more hearing care professionals are embracing person-centred care (PCC) and implementing it in their practice. The rise of person-centred care Since 2007, we have been working to bring PCC to hearing healthcare, developing tools and resources for hearing care professionals. During this time, we’ve seen a drastic increase in and commitment to PCC across the field of hearing care. Most recently, the International Organization for Standardization
prescribed that person-centred principles and strategies must be implemented in hearing aid fitting management – a landmark moment. Also last year, we saw the first ever European standard outlining the minimum requirements for PCC. The UK has always been ahead of the curve. Embedded in the NHS Constitution from 2012 is a principle to “put the patient at the heart of everything the NHS does”. More recently, NHS bodies across the UK have committed explicitly to creating a person-centred healthcare service. Change is happening at the grassroots too. There’s a growing recognition among hearing care professionals across the public and private sector too that patients’ acceptance of hearing technology and their ability to manage hearing loss
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By delivering person-centred care we are working towards individual goals with a shared understanding of what success will look like for the patient, in each situation. ~ Kathryn Lewis, President of the British Academy of Audiology, an Ida Institute partner
in daily life depends partly on them accessing care centred around their unique needs, preferences, and values. Good for patients, professionals, clinics Research indicates that PCC leads to more efficient appointments and better outcomes, making it great for patients, practitioners, and business too. Inspired by Ida is a program that allows professionals to hone and showcase their person-centred skills. We recently asked earners of the Inspired label what had changed since they shifted their approach. Seven in 10 said their patients were more satisfied, and nearly as many (68%) reported increased job satisfaction. PCC works for everyone, and with the endorsement from the World Health Organization, we are one step closer to a person-centred future in hearing care.
The Ida Institute works to advance person-centred care in audiology globally. Ida’s free tools and resources support hearing care professionals to deliver PCC and motivate people to take action on their hearing loss.
No-one can see chronic dizziness – that doesn’t mean it isn’t there Chronic dizziness is an often-hidden disability that can result from a number of different inner ear (vestibular) disorders.
P WRITTEN BY
Natasha HarringtonBenton Director, Ménière’s Society
Paid for by Ménière’s Society
atients with chronic (inner ear) dizziness can experience recurrent acute attacks of spinning (lasting minutes to days), movement-evoked imbalance or constant low-level dizziness. Additionally, they may experience hearing loss, migraine headache, tinnitus (noises in the ears), a feeling of pressure in the ears and nausea or vomiting. Dizziness (of which dysfunction of the inner ear is a significant cause) is common and can profoundly affect people of all ages. A study of adults aged 18-64 showed 23% experienced dizziness with just under half of these reporting a degree of handicap from their symptoms.1 Living in fear These often life-changing disorders can have a major impact on day-today living for a large number of those affected. Many who experience chronic dizziness fear going out. They worry about having an attack of dizziness in public, whether they will vomit or fall, or be labelled as intoxicated by those
who don’t understand. This anxiety can exacerbate sensations of dizziness, resulting in a vicious cycle. One sufferer says: “During an attack I look like I am drunk or drugged and have absolutely no control over my body. It totally incapacitates me”. People who experience chronic dizziness tell us they feel their symptoms are not fully understood. They often report family and friends don’t understand what they are going through, due to the hidden nature of the symptoms which can occur at any time, sometimes without warning. What can be done There are lots that can be done to help patients with chronic dizziness. Balance retraining exercises, specialised physiotherapeutic manoeuvres, holistic techniques (e.g. breathing/relaxation exercises, yoga and mindfulness) and in some cases medication, may all be useful depending on the diagnosis. Getting the right treatment in a timely manner means, for most, symptoms completely resolve and
the patient can resume a normal life. Many vestibular disorders, however, are complex and getting the correct diagnosis and treatment can sometimes be difficult. Although more research is needed, funding is often limited. Raising awareness of vestibular disorders, their impact and treatment is fundamental. If you are experiencing dizziness you should see your GP who may refer you to an ENT doctor or other specialist for further investigations and management.
WRITTEN BY
Debbie Cane MSc CS Senior Clinical Scientist and Audiology Lecturer, Withington Community Hospital and Manchester University
Where to go for help Please contact the Ménière’s Society for more information. The charity provides information and a listening ear to sufferers and their families, helping improve quality of life, raise awareness and fund essential research into vestibular disorders. References 1. Yardley L, Owen N, Nazareth I, Luxon L. Prevalence and presentation of dizziness in a general practice community sample of working age people. British Journal of General Practice. 1998;48:1131–1135.
T: 01306 876883 E: info@menieres.org.uk menieres.org.uk
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Post-pandemic crisis of unmet need for hearing loss Hearing technology can transform a person’s life, the challenge we currently face is how they access it.
T WRITTEN BY
Paul Surridge Chairman, BIHIMA (The British Irish Hearing Instrument Manufacturers Association)
Paid for by BIHIMA
housands of people with hearing loss have been unable to benefit from hearing instruments during the pandemic. For these people, comorbidities such as depression and cognitive decline are inevitable. We face a major healthcare crisis as a result of this unmet need. Coronavirus effect on hearing loss sufferers The pandemic brought with it three major issues for those suffering from untreated hearing loss. Firstly, stopping people from accessing ENT audiology services. Secondly, forcing them into isolation, as their hearing issues continued to worsen, making their tenuous connection with the world even more remote. Thirdly, creating a pent-up demand for hearing instruments that has untold economic, social and healthcare consequences.
Hearing industry response Our members’ overriding concern at the start of the pandemic was the speed with which the industry needed to provide remote care safely to patients. Manufacturers had to work with audiologists to swiftly move the fitting, servicing, and supply of hearing instruments online. Now our concern lies with the pent-up demand that is starting to materialise and how we can ensure people get access to much needed care. GP referral issues The hearing care crisis is further challenged by GP support. A patient’s first port of call for hearing loss is their GP. But research shows there is a knowledge gap with GPs that is stopping patients from getting access to vital audiology care. To address this issue, an educational
There are one in five adults with hearing loss in the UK, the majority of whom can be helped with hearing technology. toolkit has been created for GPs to support them in delivering better care for patients with hearing loss. Developed by the Royal College of GPs (RCGP), in collaboration with hearing loss charity RNID and NHS England & Improvement, it is sponsored by BIHIMA. The aim of the toolkit is to support and train GPs to consult more effectively with patients. Addressing unmet need There are one in five adults with hearing loss in the UK, the majority of whom can be helped with hearing technology. The pandemic will leave in its wake a vast scale of unmet need that the hearing care profession will work to address. Better hearing loss education for GPs will significantly help the healthcare community meet this need and ensure more people have access to life-changing hearing instruments.
BIHIMA represents the hearing instrument manufacturers of Britain and Ireland, working to raise awareness of the latest hearing technology, and improve the lives of people with hearing difficulties. For more info visit bihima.com Scan the QR code to access the RCGP Hearing Loss Toolkit
World Hearing Day is an invaluable opportunity to raise awareness and help us all to ensure we have the information we need to properly look after ourselves. ~ Taran Tatla, Honorary Secretary, ENT UK ©OLEKSANDR SHCHUS