1) What is the policy regarding lost and damaged aids?

NHS digital hearing aids should be treated in the same way as any other NHS aids. Most departments will already have a policy regarding this. The recent guidelines drafted by the National Committee for Professionals in Audiology have been endorsed by the Department of Health, and we would recommend that any local policies reflect these.

2) What do we do with conductive and mixed hearing losses?

a) Pure conductive losses

There is no firm evidence that non-linear processing provides an advantage to people with conductive losses. Non-linear processing algorithms used in the aids mentioned are designed for cochlear losses. Therefore, it is not clear that DSP aids give an advantage, and it may be that linear, analogue aids are appropriate for this group. However, it may be that other features such as feedback reduction are required. If using these aids with conductive losses, therefore, you should fit to prescription - NAL formulae have a correction factor to take account of air-bone gap.

b) Mixed losses

The cochlear element of these losses would benefit from non-linear processing, whilst the conductive element would not (see above). If fitting to prescription, the degree of air-bone gap would be taken into account with the targets. There is no reason therefore not to use the aids with mixed losses.

3) What does the policy on War Pensioners actually mean?

If people receive a War Pension for their hearing loss, they are entitled to priority treatment from hearing aid services within the NHS. We interpret this to mean that they should be classed as urgent, not routine, in terms of waiting times. This should be the same as any other urgent patients within your service. We do not interpret this to mean that their treatment should in any way be different from any other patient. Appropriate hearing aids to meet their audiological needs should be provided, either from within the NHS range or, if necessary, from outside this range.