News & Reviews

NHS vs Private Hearing Aids – Audiologist perspective

A recent 2018 study by Which? investigated who was the best hearing aid provider. The results drew up some interesting conclusions and today I want to look in to the comparison of NHS vs private hearing aids.

NHS vs Private Hearing Aids

You may automatically think that getting private hearing aids will result in higher overall satisfaction levels. However, the Which? 2018 study revealed that 88% of those who went private were satisfied, compared to 84% if they went to the NHS. An almost insignificant difference.

This changes though if you got your hearing aids through ‘Any Qualified Provider’ (AQP), an NHS scheme where private companies provide your hearing care, this dropped down to 75%. This is a 13% reduction compared to private.

Any Qualified Provider

AQP is becoming more widespread. The Which? study shows that privatisation of NHS audiology services has resulted in poorer satisfaction levels for patients. It seems that in order for these providers to make the business viable, they are having to compromise on quality of care.

My opinion is that AQP will change beyond recognition in the next 10 years as it is not sustainable in it’s current format. With the introduction of over-the-counter hearing aids, the majority of the non-complex caseload could be pushed over to high-street retailers without the need of a GP referral or even an audiology led hearing assessment. This would allow the NHS to focus resources on creating ‘super clinics’ that deliver specialist care to those with more complex needs. If we look at the optical model, it is very similar, and I see a future very similar to that.

Continuity and Choice

Studying the data, the main downfalls of NHS against private were the range of hearing aid choice and the continuity of care (seeing the same audiologist). There is a perfectly logical reason for this.

Choice of Hearing Aids

The NHS services a huge population of people, much more than any private business. As such, they have 1000’s of people wearing hearing aids that they need to support. At any time, somebody can come in for a repair. If they have a wide range of hearing aids on offer, they would need to stock an incredible amount of spares.

If an NHS department limits their hearing aid range to a select few, they can ensure that spares are always in stock and that after care is more consistent and predictable.

Continuity of Care

Continuity of care on the NHS is also very difficult. An audiologist may do as many as 6-8 hearing aid fittings in one day. It is very draining mentally and so managers rotate staff between testing, follow ups, and fittings to ensure that their minds stay fresh and alert. Staff will also have their own speciality in other areas like Tinnitus, Balance or Paediatrics and so they need to ensure appropriate time is given to develop and maintain this skill set.

The downside to this strategy is that care is not as personable. If you see a different audiologist each time, the rapport and relationship important to understanding your hearing profile isn’t established. This may affect the quality of the care you receive. If your needs are complex, to overcome this problem, NHS departments often push you up to more senior audiologists. This will ensure you receive the dedicated continuous care you require to obtain an optimal outcome.

From a more positive perspective, seeing somebody different each time may mean that you gather new information. They may be aware of a special program or setting the other audiologist wasn’t as familiar with. From a clinical point of view it also means that the work of the audiologist is constantly accessed and reviewed by other members of their team. It quickly highlights poor performance in a particular member of staff. This enables managers to efficiently manage poor performance through training and reflective practice.

NHS Hearing Aids vs Private

Which? states that the NHS provides hearing aids by the same manufacturers as private. This is entirely true but they failed to expand on this in sufficient detail. The technology for adult provision on the NHS is approximately 3-5 years older. I can give an example of this by looking at the features on current NHS technology.

Phonak Nathos Auto

If we look at the recently launched Phonak Nathos Auto, an NHS hearing aid, you can see it has a feature under ‘Additional Programs’ called ‘Speech in Loud Noise’. This was a feature first launched by Phonak on their Venture platform back in 2014.NHS vs Private Hearing Aids ‘Speech in Loud Noise’ is an additional program which means to access the feature you need to manually switch program. This tells me it is equivalent to the V70 model which is in the advanced format. On the private sector you have the option to get the premium model which makes this feature fully automatic. It may not seem that significant but for many people, understanding the controls and functionality of a manual program can be difficult. Having this feature fully automated means it is used appropriately when required and could mean the difference between hearing the conversation and not.

This is of course just one example of the products that are available on the NHS but generally all the manufacturers apply the same principles.

Appearance of Hearing Aids

This is a slightly difficult one to address because it varies hugely between NHS departments. A whole range of hearing aids are available for purchase on the NHS contract. However, the use of in-the-ear hearing aids is often limited to those with a medical condition such as microtia.

Statistically, the study demonstrated that there was a 23% difference between satisfaction of appearance between NHS and private. On the surface, not a huge number but my experience is that the appearance is one of the main reasons why people go private. That being said, 72% of the study were still happy with the appearance of their NHS hearing aid which can’t be ignored.


The results suggest that, if you are thinking of getting a hearing aid, the route you take will depend on a number of factors.

  1. You are more likely to be satisfied with your NHS hearing aid if it is delivered by the NHS rather than their AQP counterparts.
  2. The appearance of the hearing aid, along with the restricted range of choice may impact on whether the hearing aid is meeting your expectations.
  3. Continuity of care – not seeing the same audiologist at your appointments may hinder satisfaction levels. However, there are also positives to this approach.

I would suggest that if you are in doubt about which route to go, and you are willing to wait, start with the NHS. You have nothing to lose and it will give you a point of comparison if you decide to go private. There is no denying the figures that 84% of people that went to the NHS were satisfied. If you are part of the 16% that weren’t, then please do get in touch today to see if we can help.





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