Equal Health Outcomes for All. Why Hearing Loss Must Be Part of Every Health Conversation
A starting point
Inclusion of people with hearing loss isn’t an add-on to good healthcare; it’s at the heart of it. Hearing loss is a hidden disability that shapes every step of a person’s health journey, from making an appointment to understanding a diagnosis and following a care plan. When we design communication for normal hearing, we unintentionally design exclusion. In this article I share a people-first approach with practical, low-cost ways health professionals can make their practices genuinely accessible and improve outcomes for everyone.
This Isn’t Just Theory. It’s My Life
Clarity isn’t a nice-to-have, it’s an absolute must as it provides safety, dignity and equal access. My life has taught me that quality of communication is linked to quality of life, from childhood speech therapy, silent swimming lessons, inaccessible exams, years of lip reading, a career in deaf awareness training, sail training, and my work as a Health & Hearing Coach.,
Hearing loss is unseen, and many people won’t disclose it, sometimes because of stigma, sometimes because they’re tired of explaining and often because they’ve learned the hard way that disclosure doesn’t always change anything.
The Result? Many people struggling in an everyday life that wasn’t built with them in mind.
Why this matters in everyday practice
In healthcare settings when communication fails, everything around care starts to unravel. People miss appointments when they don't hear their name being called, misinterpret medical advice, medication or follow-up steps, not because they can’t follow instructions; it’s a healthcare system failing to communicate in a clear and accessible way.
Hearing loss also affects health indirectly. Listening fatigue from concentrating hard to lip read, piecing together context and filling in the gaps can be exhausting. As a result, people start to avoid group situations or appointments that make them feel incompetent or anxious. Over time, that avoidance turns into isolation and isolation can snowball into poorer mental and physical health.
My aim in this article is to keep things simple and doable. I’m not asking you to become a communication or a hearing loss specialist. I’m inviting you to build a small set of everyday habits that make your practice kinder, clearer, safer and effective, not just for people with hearing loss.
The difference between “we called you” and “we included you”
To give you some examples of what can go wrong in healthcare settings.
An all-too-common scenario is when someone arrives for a hospital appointment, they tell the receptionist about their hearing loss and go to sit in the waiting area which is neatly tucked away behind a pillar. There is no visual call system, just doctors calling patients’ names from the doorway of their consulting rooms. After an hour of waiting the patient learned they’d missed their appointment.
They hadn’t missed their appointment; the system had missed them.
No one wakes up that morning intentionally planning to exclude anyone, but if your practice relies on people hearing, you’ve accidentally made hearing a requirement for care. The fix is simple: set up visual boards, or a ticket system or make sure a staff member checks seating areas. Small, thoughtful changes can build trust and reduces anxiety.
Another example in hospital theatres, where women with hearing loss have given birth via emergency caesarean, unable to understand what was being said due to people wearing medical masks. For these women, one layer of understanding has been taken away, leading to additional panic, stress and anxiety. Ensuring one of the theatre team is there to communicate clearly turns a very distressing time into a more supportive experience. In a crisis, the most human act is to make sure someone understands.
Hearing loss isn’t a singular thing
People often imagine hearing loss as lower volume but it’s far more nuanced. Different frequencies can be affected; some people hear vowels more than consonants, which is why “s,” “sh,” “ch,” and “t” can vanish and sentences lose definition. Background noise matters hugely because hearing aids amplify everything - the person speaking as well as the coffee machine behind them. Some people use hearing aids; some don’t. Some rely on lip reading, captions or British Sign Language. Many live with tinnitus, which can spike with stress or fatigue. And each person’s confidence and preferences differ day to day.
A small but vital point: hearing aids don’t restore normal hearing in the way glasses can correct vision. Please don’t ask someone to turn them up. It’s not a volume knob; it’s a complex piece of tech trying to help a complex ear-brain system.
Inclusive communication
Think of inclusive communication as a handful of reliable habits you can use anywhere - clinic, ward, coaching session, face-to-face or video call.
Sit or stand where your face is clearly visible. Avoid strong back-lighting that throws you into silhouette. Speak at a steady pace and pause between ideas. If you switch topic, say so: Let’s talk about the medication now. Signposting helps lip readers anticipate vocabulary.
Instead of asking, Do you understand? try, Just to make sure I’ve explained clearly - what will you do if the pain gets worse tonight? It’s gentle and practical, and it places responsibility on the clarity of your explanation, not on the person’s ability to admit confusion.
Reduce noise. Shut a door, move away from a whirring printer, or choose a quieter space if you can. To a hearing aid, a coffee grinder and a human voice are both sound. When you lower the non-essential noise, everyone benefits, including you.
A few lines written during the consultation - doses, timings, red-flag symptoms - can be game-changing. Hand the note over, text it or upload it to your portal. This is not extra admin; it’s a safety net.
Ask, How would you like me to follow up - text, email or a written summary? If you’re online, say, Captions are on; let me know if you’d like me to slow down or repeat anything. Make adjustments normal, not special.
In meetings or group education, set the tone early: one person speaks at a time, and people say their name before they speak. It keeps things tidy and lets people track who’s talking. Share agendas in advance and summaries afterward. Small courtesies; big dividends.
Problems often start long before a person sits down with you. If the only way to book is by telephone, you’ve already excluded some people. Offering online booking, email and text routes is a simple way to widen access. Confirmation messages can include a line such as, If you use hearing aids or have hearing loss and would like any adjustments (e.g., written instructions, captions), let us know, happy to help. It signals inclusivity.
On arrival, a visual board or ticket system ensures no appointments are missed. In your clinical record, add a clear flag for communication preferences.
For video calls, turn on captions by default, not on request. Tell people in advance that captions will be available and follow up with a brief transcript or summary. Zoom, Microsoft Teams and Google Meet all offer captioning features, and they’ve improved a great deal, so use them.
The quiet inequity: incidental hearing
I wonder if any of you are ever aware of information that floats around workplaces and in company without ever being written down. A room change. A time shift. A quick decision made in the corridor. Hearing people absorb these scraps effortlessly; people with hearing loss miss them entirely unless they happen to be watching at the right second. This is called incidental hearing, defined as the act of picking up information through casual listening, without direct intention to learn, and it’s one of the most overlooked barriers. The fix is straightforward: if an item matters, put it in writing where people expect to find it. Once you build the habit of writing down small details, you eliminate a disproportionate amount of confusion and embarrassment.
When the barrier is confidence, not hearing
For many, the heavy emotional toll of always being behind can mean the barrier is confidence, not hearing. People with hearing loss can feel a step slower in fast conversations, and the effort to keep up can be exhausting. Some withdraw rather than ask for repeats. Some nod along to avoid seeming difficult. Over time, this erodes confidence in group settings like classrooms, workplaces and social gatherings. You can help more than you realise by setting a friendly tone: If I speak too quickly, just wave and I’ll slow down. Or offering to move somewhere quieter if the room gets noisy. Those offers are small gifts. They communicate You’re not a problem to solve. You’re a person I want to include.
When technology earns its keep
Technology is wonderful when it does what it says on the tin. A few tools are worth your energy:
Closed captions in video platforms: switch them on by default in your video hosting settings and say they’re available.
Speech-to-text reporters for complex, high-stakes meetings: a qualified Speech-to-Text Reporter (STTR) provides a live, verbatim transcript of what’s being said, this immediate access to accurate information transforms understanding, enabling full participation in discussions and decisions.
Hearing loops: put up clear signage, keep them maintained, and test regularly.
Written or digital summaries after appointments: most patient portals make this easy. As do AI transcriptions provided by Zoom, for example.
Bluetooth microphones or remote mics: some people have devices that pair with their hearing aids. Give them a moment to set up - it absolutely pays off.
None of this need cost much, it’s the digital equivalent of kindness and good manners.
A short note on rights and responsibilities
It helps to remember that this isn’t just kindness; it’s also a right.
In the UK, the Equality Act 2010 protects people if their hearing loss or tinnitus has a substantial, long-term impact on daily life. Health professionals have a duty to make reasonable adjustments so that information and care are accessible.
This sits comfortably alongside our shared ethos: respect, support and therefore accountability. Clear communication does no harm; it prevents harm.
Language, identity and respect
In the UK you’ll hear D/deaf, hard of hearing, partially deaf, and hearing loss. Some people dislike hearing impairment because it implies deficiency. Deaf with a capital D often signals connection to the Deaf community and British Sign Language, with its own culture and pride. The simplest approach is the most respectful: ask the person what language they prefer and mirror it as terminology is so personal. Some people come from hearing families and don’t belong to the Deaf community inevitably not feeling deaf enough or hearing enough, a tough place to be.
Cost and time
Let’s be honest, inclusive communication saves time and money in any health care setting.
When people hear and understand the first time, you avoid repeat calls, clarifications, errors and complaints.
But also consider the emotional cost which lack of clarity and inclusion brings.
To decide where to start, choose one or two changes with the biggest ripple effect - my favourites are: enable captions by default for video; create a simple written after-visit summary; add a communication-preference flag in your records; and install a visual call system.
You and your clients will experience the difference.
Your quick-start checklist
Here’s a simple list to get started with this month:
Offer more than one booking route (not just the phone).
Record communication preferences clearly in your notes and make them visible to all staff.
Use a visual call system; don’t rely on calling names into a noisy room.
Ensure faces are clearly visible; avoid sitting with your back to a window, even when online.
Slow down, signpost, and pause between topics.
Check for understanding and avoid dismissing the client with It doesn’t matter.
Provide a brief written summary after each appointment.
Turn on captions by default for online appointments and share a summary or transcript.
Keep hearing loops maintained and signposted.
Write things down, details such as room/time changes.
Small steps, big impact.
Disability doesn’t equal inability
With small adjustments and a bit of patience, people thrive. That’s why I’m optimistic. The gap isn’t our capacity; it’s our defaults. Change the defaults and you change the outcomes. many of the barriers are similar, if not the same, at all stages of a hearing loss journey.
Many have had very distressing experiences which has fostered reluctance towards self-care especially in medical settings.
Many are in self-denial about the extent of their hearing loss and it can take on average seven years before they seek referrals to get a hearing test.
Often there is a lack of knowledge of what rights and services they are entitled to and consequently there is little self-advocacy. Knowledge is empowerment.
As health coaches and health professionals, we act as partners, helping clients build the knowledge, skills, and confidence to make informed decisions and overcome obstacles to improve their overall well-being.
Closing thought
Good care is, at its core, good communication. When we face people, slow down a fraction, reduce noise and write things down we don’t just make life easier for people with hearing loss, we can advocate for, and empower, everyone.
Nobody should be left out of the conversation about their own health: That’s the standard I want for all of us.
Here are a few references & signposts for further information:
Royal National Institute for Deaf People (RNID): Practical guidance for professionals, including how to enable captions on online video hosting platforms, and broader advice on services and accessibility.
Equality Act 2010 (UK): The legal framework protecting people whose hearing loss or tinnitus has a substantial, long-term effect on daily life. In healthcare this underpins the duty to make reasonable adjustments and ensure informed consent is genuinely accessible.
British Deaf Association (BDA): Context on Deaf culture and British Sign Language, supporting respectful terminology and engagement with the Deaf community.
National Deaf Children’s Society (NDCS): Insight into access and education for children and families, relevant for paediatric and family-centred services.
Tinnitus UK: Practical resources for understanding and managing tinnitus, including the common link with stress and fatigue.
Ménière’s Society: Information on vestibular conditions when balance, dizziness and falls risk intersect with hearing loss.
NHS Accessible Information Standard: Based on five key principles: Ask, Record, Flag, Share and Meet.