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Health and Social Care Committee

Inquiry into the contribution of community pharmacy to health services in Wales


CP 35 – Action on Hearing Loss Cymru



Dear Chair


Action on Hearing Loss Cymru response to the Health and Social Services Committee Inquiry into the contribution of community pharmacies toward health and wellbeing services in Wales.

7 October 2011


About us

Action on Hearing Loss Cymru is the new name for RNID Cymru. We're the charity working for a Wales where hearing loss doesn't limit or label people, where tinnitus is silenced – and where people value and look after their hearing.


Our response

Action on Hearing Loss Cymru welcomes the opportunity to comment on this Inquiry and the contribution of community pharmacies in Wales. We believe that community pharmacies have a vital role to play as a means of expanding the reach of health and wellbeing services in Wales.


Our response will focus on key issues that relate to people with hearing loss. Throughout this response we use the term 'people with hearing loss' to refer to people with all levels of hearing loss, including people who are profoundly deaf. We are happy for the details of this response to be made public.


We cannot answer every question but have chosen to respond to the part of this call for evidence where we feel we can add value to the Inquiry.



It is estimated that there are 534,000 people with hearing loss in Wales. More than 300,000 people would benefit from using hearing aids – 1 in 10 of the population (10%). Almost two out of three people (65%) with hearing loss are over the age of 65. 


Because of the ageing population, the number of people with hearing loss is set to grow by 14% every 10 years.


Action on Hearing Loss Cymru believe that with the help of community pharmacies we can help the people of Wales to:


·         acknowledge their hearing loss and take action

·         protect themselves against hearing loss and tinnitus


The current situation


·         Hearing loss is widespread, and needs urgent action. 

·         Hearing loss can impact on health, wellbeing and employment.

·         Noise induced hearing loss is preventable.

·         On average, there is a 10-year delay in people seeking help with their hearing loss.

·         Diagnosis of hearing loss in adults is opportunistic and ad hoc.


About people with hearing loss

Research reveals that people with hearing loss have a higher prevalence of depression, anxiety and stress. A recent study shows that older people with hearing loss are 2.45 times more likely to develop depression than those without hearing loss.[1]


Recent research also shows that people with mild hearing loss have nearly twice the chance of developing dementia compared to people with normal hearing. The risk increases threefold for those with moderate and fivefold for severe hearing loss.[2]


Research we conducted in 2007 into the employment experiences of severely and profoundly deaf people, found that at a time of near full employment, deaf people were four times more likely to be unemployed than the general population, with negative attitudes from employers seen as the main barrier to getting a job.[3]


Noise-induced hearing loss is a preventable condition. Four million young people are putting their hearing at risk through their listening habits[4] (including their use of MP3 players and going to music events), but the government does not provide public health information that allows audiences to make an informed choice about the dangers of overexposure to excessive noise.


On average, there is a 10-year delay in people seeking help with their hearing loss


Early diagnosis and intervention is fundamental to preventing and reducing the impact of hearing loss, supporting independence and wellbeing and preventing mental ill health. However, on average, there is a 10-year delay in people seeking help with their hearing loss.


Poor access to health services for people with hearing loss causes health inequalities


Currently many people with hearing loss experience difficulties accessing health services and public health information that could enable them to manage their health effectively. This is due to difficulties accessing appointment systems and health settings and difficulties communicating with healthcare staff.


The Inquiry


Action on Hearing Loss Cymru has approached local health boards across Wales with the aim of working with community pharmacies to raise awareness of the need for people to protect their hearing and for a hearing check. LHBs also received information about Action on Hearing Loss, what support we offer and tips for communicating with people with hearing loss.


As outlined above people with hearing loss can wait up to 10 years before seeking assistance and are more likely to need other services (such as mental health) if they do not have the right support. We believe that with the help of community pharmacies we can enable people to seek help sooner.


We already have the support of one LHB and are in talks with individual health boards across Wales. Here is an outline of our proposal:


Action on Hearing Loss Cymru would like to reach out to people within Wales as extensively as possible. We want to let people know about services that may support them; these may be services we provide or ones provided by our partners which we can signpost them to. We particularly want to let people know about how to:


·         Check their hearing

·         Protect their hearing

·         Access support services


There are strong drivers for pharmacies to run a campaign relating to hearing loss, not least that there are 534,000 people in Wales who are deaf or hard of hearing. Approximately 75% of these people are over the age of 60 therefore are statistically more likely to be accessing medication through their pharmacist. 


By reaching out directly to these people and demonstrating an awareness of their needs, pharmacies will confer a commercial advantage over competitors who are unable to serve this customer group as well.


Proposals are currently being considered in Scotland for pharmacists to receive a basic level of deaf awareness training. Within Wales, we could achieve similar levels of awareness amongst pharmacists by building training materials into this public health campaign. Wales has the opportunity to be at the forefront of this agenda, and to demonstrate its success to England and the other devolved countries.


·         the current and potential impact on demand for NHS services in primary and secondary care of an expansion of community pharmacy services, and any cost savings they may offer;


Earlier identification of hearing loss helps individuals adapt earlier, leading to higher quality of life. Earlier identification of hearing loss also releases significant cost savings to the public purse. We recently commissioned a cost benefit analysis of a hearing screening programme. This showed that the benefits of hearing screening for older people clearly outweigh the costs, representing a benefit cost ratio of more than eight to one for people aged over 65.[5]


This group would be a clear user of community pharmacy and a valuable audience for our information.


We cannot draw a direct comparison with raising awareness through community pharmacy, but this shows that even with an increased demand on secondary care services such as audiology there is a cost benefit to more people having their hearing tested.






We recommend that community pharmacy work with us to help raise awareness of how people can protect their hearing and take a hearing check.


1.   Although it is clearly a public health issue that demands action, hearing loss is not currently on the public health agenda. We recommend that hearing loss is recognised and responded to through appropriate mechanisms including Public Health Wales and community pharmacies.

2.   We recommend that community pharmacy take our offer of support to help raise awareness.

3.   As community pharmacy extends its reach beyond medicine dispensary we believe it can have a key role to play in the health and wellbeing agenda, where people should be actively encouraged to address the onset of hearing loss, so as to avoid related conditions including depression, anxiety, dementia and social isolation.



Contact details

Mary van den Heuvel

Policy and Research Officer

Action on Hearing Loss Cymru

Ty Tudor, 16 Cathedral Road, Caerdydd/Cardiff, CF11 9LJ



[1] Saito H, Nishiwaki Y, Michikawa T, Kikuchi Y, Mizutari K, Takebayashi T, Ogawa K ‘Hearing handicap predicts the development of depressive symptoms after 3 years in older community-dwelling Japanese’ J Am Geriatr Soc. 58(1):93-7. 2010

[2] Lin, Frank, E Jeffrey Metter, Richard O’Brien, Susan Resnick, Alan Zonderman and Luigi Ferrucci ‘Hearing Loss and Incident Dementia’. Arch Neurol 68(2), 2011

[3] RNID Opportunity Blocked 2007

[4] Hughes EA, Fortnum HM, Davis AC, Haggard M, Coles R, Lutman ME ‘Damage to hearing arising from leisure noise’. British Journal of Audiology 20, 157-164, 1986.

[5] RNID and London Economics Cost Benefit Analysis of Hearing Screening for Older People. London: RNID, 2010.