Common model procedures for the UK
In the UK there are two types of hearing aid service – the public sector and the private sector. The public sector service is free of charge. The service in the UK has recently undergone a change and the procedures detailed below are currently being carried out by public sector staff in England. The private sector is completely separate and involves payment for hearing aids. Hearing aid dispensers who work in the private sector are regulated by a different professional body to those in the public sector. However, exact procedures tend to vary throughout the country in the private sector and so only the public sector procedures are summarised below.
1. First Assessment visit (at least 45 min)
- Medical history, including manipulation ability, vision
- Glasgow Hearing Aid Benefit Profile Part 1
- Pure Tone Audiometry (Air and bone conduction)
- Uncomfortable loudness levels – are optional, according to local protocol
- Tympanometry where indicated
- Pre-fitting counselling, including modifying expectations if necessary
- Discuss hearing aid options and agree type/model with client
- Impression taking, choice of venting/tubing
2. Fitting (at least 45 min)
- Check earmould for comfort/insertion ease – modify/file if necessary
- Perform Real Ear Measurements (REM) to verify fitting to target by agreed protocol; adjust to target if required
- Evaluate subjective sound quality (including own voice) and fine tune hearing aid if necessary
- With aids on, teach client how to
- change battery
- operate controls
- switch between programmes
- insert and remove
- use loop
- take care of aids
- Advise on using and getting used to aids
- Issue written information on the aids, local services, etc
- Refer to Volunteer/user support service if exists
3. Follow up 8-12 weeks (at least 30 min)
- Ask how client is getting on with their hearing aid(s)
- Glasgow Hearing Aid Benefit Profile Part 2
- Follow up on Glasgow responses, and ask about problems with insertion, comfort, sound quality, adequacy of loudness, loudness discomfort, noise intrusiveness, telephone use, battery life, cleaning.
- Check use of different programmes, loop
- Fine tune if necessary based on client’s comments
- REM if necessary
- Assess need for hearing therapy or Assistive Listening Devices, further follow-up visits.
- Modify programming of aid if necessary
- Repeat REM if programming changed
- Check high level output (optional) using an 80dB stimulus
- Clients are offered an open-access repair service, which they can use if they are experiencing any problems with their hearing aid.
Read on: Rehabilitation pathway in the Netherlands or Germany.