Royal National Institute for Deaf People
Innovating to make hearing loss diagnosis and treatment more accessible
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Hearing loss affects over 12 million people across the UK, but one third of people, remain undiagnosed. And around six million people could benefit from hearing aids but only about a third have them.
The route to hearing loss assessment is convoluted and lengthy. Royal National Institute for Deaf People (RNID), is the national charity supporting people who are deaf, have hearing loss, or tinnitus. They are on a mission to ensure as many people as possible can access diagnostic services and secure treatment.
We partnered with RNID on a pro bono basis to improve access to diagnostics and treatment for age-related hearing loss, which is their biggest strategic challenge.
Together, we identified and evaluated the many barriers to hearing loss diagnostics and treatment services, and recommended solutions that RNID could implement to ensure that more people can hear better.
By engaging a wide range of stakeholders, from clinicians, to innovators, to academics, we worked with RNID to create a fresh vision for improving access to hearing loss diagnostic and treatment pathways. The work resulted in RNID preparing to establish a hearing loss innovation hub which will convene multiple stakeholders across the hearing loss ecosystem – to unite and collaborate on innovative solutions. The hub will be launched later this year.
Hearing loss is an almost invisible condition that suffers from lack of investment and innovation. Our vision is that people will regularly check their hearing and act on hearing loss promptly. We could facilitate this through technological advances that would allow people to access a range of treatments quickly and easily, including from their own home.”
Key successes
- Developed an approach to hearing loss that uses existing healthcare settings used by the public, such as pharmacies and primary healthcare services, to raise awareness of hearing loss and promote access to RNID’s digital hearing assessment tool.
- Utilised health economics tools to identify the scale of the problem and provide a qualitative assessment of access barriers.
- Engaged influential stakeholders, including population health experts, integrated care experts, medical technology providers, and academia to assess and validate proposed solutions.
- Established the strategic need for an innovation hub to elevate the conversation around age-related hearing loss and promote innovation in diagnostics and treatment.
Accelerating audiology innovation
Age-related hearing loss affects 42 percent of people over 50 and 72 percent of those over 70. The challenge is that it can take up to 10 years to get a diagnosis. For those experiencing age-related hearing loss, an estimated 30 percent don’t get help, often because they don’t know how or where to receive it. And of those who do seek help, many people don’t complete the pathway because of the many barriers along the way.
Additionally, those experiencing hearing loss are also more likely to have other physical and mental health conditions, including cardiovascular disease, diabetes, depression, and isolation according to RNID. Their research shows that hearing loss in mid-life is the largest potentially modifiable risk factor for dementia. The condition also disproportionately affects those from low socioeconomic backgrounds, as well as Bangladeshi, Black African, or Pakistani communities. So, improving access to hearing loss diagnostics and treatment presents an opportunity to improve healthcare outcomes. But it’s also a step towards more inclusive access to care for minorities and those in communities with higher economic inequalities, for example, in the north of England – where hearing loss is more prevalent.
Age-related hearing loss is an issue in the workplace, too, with one in eight people of working age having some form of hearing loss. People with hearing loss become more likely to face unemployment, daily challenges at work, or early retirement due to lack of support. RNID aim to make speaking about hearing loss more mainstream. Given that the nation needs people working for longer, opening conversations on hearing loss could support not only better economic activity but provides opportunities for patient quality of life improvements in later life.
The hearing loss pathway has had limited innovation in the last 20 years since the rollout of digital hearing aids on the NHS. To change this, we want to encourage collaboration across a host of contributors including academics, clinicians, technology providers, patients, and future patients to support the development of new solutions which meet the needs of those experiencing hearing loss. These should ensure equitable access to diagnosis and treatment, and ultimately, improve the lives of those experiencing hearing loss.”
There are over 12 million people in the UK who are deaf, have hearing loss, or tinnitus. It was clear from the get-go how high impact our collaboration was. RNID wanted to raise awareness of hearing health and reduce the barriers to people getting a hearing diagnosis”
A fresh vision for hearing loss
We collaborated with RNID to identify the barriers to diagnostic services and develop an action plan to ensure more people can access appropriate treatment.
Our experts across strategy, operations improvement, diagnostics, and health, developed a detailed hearing loss pathway map and identified 55 individual barriers across three key stages in a patient’s journey to an audiology diagnosis. These included: awareness and seeking help; entry to pathway; and securing an appointment with an audiologist. We grouped these under themes and using an evaluation framework, worked with RNID to classify and evaluate the most significant obstacles. The biggest three hurdles identified were the lack of innovation in audiology in recent years, patients’ lack of access to reliable information, and clinicians’ lack of awareness or access to reliable information. We combined our expert knowledge to develop a list of 58 potential interventions to address these top three barriers.
Then, we developed a digital scoring tool to evaluate all 58 interventions against agreed evaluation criteria. The survey scores were compiled and analysed to identify prioritised interventions for immediate action and a longer-term strategic focus.
From the beginning, RNID was highly engaged and eager to take ideas on board, I found it incredibly fulfilling to advocate for such an important topic that sometimes doesn’t get the attention it deserves. I’m excited to see how RNID continues to impact the lives of millions of individuals across the UK.”
Making every contact count
In the near term, RNID will take a population health approach to hearing loss, reflecting the move to an Integrated Care System (ICS) across the NHS, which brings together NHS organisations, local authorities, and others to improve health and reduce inequalities across the UK.
Based on the NHS ‘Make Every Contact Count’ approach, the intervention rethinks the role of a broad group of healthcare professional interactions with patients, including pharmacies, General Practitioners, community nurses, and other primary healthcare providers who engage with RNID’s target audience on a regular basis.
In the longer term, RNID will use its independent convening power to establish an innovation hub to bring together organisations from healthcare, academia, and technology innovators, to collaborate and develop innovative solutions for specific challenges within the hearing loss diagnosis and treatment pathway.
The work PA has done with us has really advanced our thinking and given very valuable introductions to influential stakeholders. It’s hugely helpful to have had our plans so thoroughly reviewed and tested, and our ambitions strengthened. I’m delighted that RNID and PA are continuing to work together.”
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