Audiology - Salford Community

Adult Hearing Services

1.1 Diagnostic Hearing Assessment Service  

The Audiologist will take a detailed medical history and will carry out an examination of your ears. You will be asked questions about your hearing difficulties and asked to outline up to five situations in particular that cause you most concern with your hearing.  An audiogram will then be performed, which is a method of evaluating your hearing loss. The results will be discussed with you in detail, along with the appropriate management to help you with your hearing loss. We will give you a leaflet that describes your hearing and our agreed management plan.  

Most staff are trained in ear wax removal. If wax is blocking your ears we will try to remove on the day or at the next visit. We have a variety of removal methods available. We will discuss the options with you to decide on a method of removal that best suits you.  

If your hearing test results indicate that the preferred treatment option would be to fit you with hearing aids, the Audiologist will assess the most appropriate hearing aid fitting process dependant on the nature and severity of your hearing loss: 

• taking ear mould impressions and arranging a mutually convenient appointment for your hearing aid fitting

• arranging for hearing aids to be fitted via a ‘slim tube’ 

If the assessment shows you would benefit from a medical opinion, we will discuss this with you and offer you a referral to Ear Nose and Throat (ENT) service. You may be advised that you need a scan and this can be arranged directly by our Advanced Practitioner (link to AP section – section 2).  

For adults who are unable to attend our clinics, we offer home visits. These must be requested by the GP. We can do a full hearing test, fit hearing aids and offer follow up visits at home.   

More information on hearing loss and hearing aids can be found at: https://rnid.org.uk/  

Information and support on living with a hearing loss can be found here: Resources to help you manage your hearing loss (idainstitute.com)  

1.2 Hearing Aid and Rehabilitation Service  

Digital Hearing Aid Service

At your hearing aid fitting appointment, the Audiologist will programme your new hearing aids via a computer, ensuring that the performance of your hearing aid is tailored to your individual needs. This may be verified by carrying out a ‘real ear measurement’ (REM) which involves placing a tiny tube into your ear to measure the hearing aid’s performance in your ear. Adjustments can then be made to personalise the hearing aid settings to your needs.  

The audiologist will explain how to use your hearing aid and demonstrate all aspects of the hearing aid operation. You will be shown how to fit the ear mould/slim tube in your ear and you will be provided with the relevant information in a format this you can read. 

It is important that we review your hearing aid provision to make sure that you are not experiencing any difficulty. This will be carried a few weeks after the hearing aid fitting via a telephone call or it may involve a further visit to the clinic. 

Hearing Aid Batteries are provided free of charge for NHS hearing aid provision and can be collected from the main reception counters at the Gateway centres. We are unable to provide batteries for privately purchased hearing aids.

We recommend you contact us for a ‘Service’ visit every 6 months to have your ears checked, your hearing aids serviced ad your ear piece tubes changed.  

Information on your new hearing aids 

• We appreciate that when you are fitted with hearing aids for the first time there is a lot of information to take in all at once. 

• To help with this we can recommend these video’s to help you understand how to use your hearing aids and what to expect: C2 hear online  

• If you have any further questions then please contact us as soon as possible and we will try and help you. 

Assistive Listening Devices (ALDs):  These devices help to make noises around the home louder and clearer e.g. the doorbell or TV. They can work with hearing aids or separately. They can be provided for free by Salford Council or bought privately.  

• Information on Salford Sensory Service:  Visual and hearing impairment • Salford City Council 

• A website to get advice and purchase ALDs: https://www.connevans.co.uk/  

Cochlear Implants:  

For people with severe and profound deafness, hearing aids may not give much benefit and it may be difficult to hear people talking, especially if lip reading is not possible. A Cochlear Implant bypasses the damaged inner ear and sends clearer sounds to your brain. This means speech is easier to hear and you may rely less on lip reading e.g. you may be able to have a conversation on the phone. A Cochlear Implant requires an ear operation with an over-night stay in hospital.  

We can discuss your suitability for a Cochlear Implant, provide information on Cochlear Implants, and offer you a referral to our local implant team.  

Information on the Manchester Cochlear Implant team can be found here: The Manchester Adult Cochlear Implant Programme - Manchester Royal Infirmary (mft.nhs.uk)  

Information on how a Cochlear implant works and why they may be better than hearing aids, can be found here: https://youtu.be/kcwatbIWpkY 

Advanced Practitioner Service  

Our Advanced Practitioner (AP) works closely with Ear Nose and Throat (ENT) department to provide early diagnosis and treatment of ear-related conditions. This means ear conditions can be investigated in Audiology, with timely referral to ENT when needed. This service streamlines patient pathways and ensures early detection and treatment of ear disease.

Tinnitus and Hypercusis Service

Tinnitus is the name given to noises that can sometimes be heard by people when there is no external sound present. Tinnitus can be heard in one ear, both ears or described as ‘in the head’. People describe hearing ringing, whistling, humming or buzzing noises and it can also be complex sounds, like the roar of an ocean. 

The term Hyperacusis is generally applied to people who experience the sounds of everyday life as intrusively loud, uncomfortable, and sometimes painful. Some people notice an increase in sensitivity after they have had a difficult life event, for example, bereavement. In many people, though, there is no clear reason why hyperacusis started. 

Access to the tinnitus and Hyperacusis service is normally via a referral from a GP or an Ear, Nose and Throat (ENT) doctor. During COVID, we have offered ‘virtual appointments’ and this is still available.  

During the initial appointment we will: 

• Discuss the problems you are experiencing due to your tinnitus and the impact it is having on your life 

• Give an explanation of how tinnitus is generated 

• Provide you with information regarding tinnitus management 

• Offer any other aspects of hearing rehabilitation if necessary 

• Address any questions or queries you may have 

 During any subsequent appointments we will: 

• Check your progress 

• Discuss any further help or advice that may be required 

• Offer any other aspects of hearing rehabilitation if necessary 

Please see the link to our Tinnitus patient information sheet (link under ‘related patient information sheets). 

Useful sources of information on tinnitus and Hyperacusis: 

The British Tinnitus Association

Information on Tinnitus: British Tinnitus Association 

Information on Hyperacusis: Hyperacusis | British Tinnitus Association  

Royal National Institute for the Deaf : Tinnitus - RNID

Adapted Adult Service

We have a new service for adults living in Salford with a Learning Disability, and/or Autism or Dementia.  

The service offers:  

• Easy read letters and written information.  

• Appointments with the same, specially trained staff at each visit.  

• Extra time and more frequent visits, as needed.  

• A flexible approach to the hearing test.  

• Two members of staff to support adapted testing.   

• A wide range of hearing tests (including fully automatic hearing tests).  

• Hearing aid fittings to suit individual needs.

• Support to use Assistive Listening Devices.

• On-going support and counselling for patient, families and care staff.

• Support to promote communication and increased awareness of surroundings and environment.

• Onward referral for dizziness, tinnitus and hyperacusis.

• Joint working with Ear, Nose and Throat doctors to treat ear disease.

• Home visits, as needed.

• Hearing assessments every 2 years, following national recommendations.   

Bone Anchored Hearing Aid Service

A BAHA is an alternative hearing aid device that may be considered appropriate for patients who present with a range of complex hearing losses and/or conditions of  the ear that prevent the effective use and wear of a conventional digital hearing aid. 

The BAHA is attached to the head via a titanium implant or magnet which is inserted by an ENT (Ear, nose and throat) Consultant during a surgical procedure. Patients are assessed for their suitability for BAHA by a Specialist Audiologist. The BAHA assessment includes a clinical trial of a BAHA on a headband. This allows the potential user the opportunity to experience the potential benefits of Baha before considering and consenting to the surgical procedure. 

There are a range of BAHA devices available depending on the severity of hearing loss and the BAHA is available in different colour options.  Baha is not appropriate for all types of hearing losses. Referral into the BAHA service is routinely via ENT or Audiology Services. 

More information regarding BAHA can be found at: http:www.cochlear.com

Paediatric Service 

6.1 Diagnostic Hearing Assessment Service  

You should receive an appointment within six weeks of us receiving the referral. We offer hearing test appointments at all the Gateway centres making this more convenient for you. 

The Audiologist will take a detailed medical history and will carry out an examination of your child’s ears. A hearing test will then be performed depending on the developmental age of your child (see hearing test details below).  

The results will be discussed with you in detail, along with the appropriate management of your child’s hearing loss. 

Performance testing: This test involves playing sounds through insert headphones, speakers or a small hand held piece of equipment in front of the child. The child, in response to the sound, is asked to participate in a game i.e. placing a man in a boat. This can test either the two ears working together and provide ear specific information when using inserts or headphones. 

Play/Pure Tone Audiometry: Various sounds are played through headphones and the child  will either be asked to place a man in a boat, say ‘yes’ or press a button in response to the sound. This enables us to test the child’s response from each ear individually. 

Visual Reinforcement Audiometry: Visual Reinforcement Audiometry (VRA) is a test used for children from the age of eight months. The child sits on the parent/guardian’s knee and a sound is played through speakers or earphones. The child is then rewarded for turning to the sound by seeing dancing puppets in a box. 

If your child is too young to have any formal hearing assessment they will be tested using otoacoustic emissions (OAE) which is a similar test to which they had at birth. More information regarding this can be found on www.hearing.screening.nhs.uk 

Other tests may be carried out as part of the hearing assessment e.g. speech testing, toy tests etc where required. 

6.2 Hearing Aid Rehabilitation service  

For children who require hearing aids we provide a family friendly auditory rehabilitation service. A range of digital hearing aids are available dependant on the severity of the child’s hearing loss. 

If a child is unable to wear conventional digital hearing aids and may benefit from an implantable hearing aid, the paediatric Audiology team can arrange for the child to be assessed. 

We have close links with education, and children are supported throughout nurseries and school by teachers of the hearing impaired. A member of the Audiology team also goes out to schools to perform regular checks on the hearing aids. 

There is support for the families of deaf children through the NDCS family officer whose main role is to provide information and advice regarding education, benefits, communication and technology. 

More information can be found on www.ndcs.org.uk. 

Salford Hearing aid Information booklet (children): Hearing aid information Apr 20.pdf 

6.3 Transition service  

As children move from the paediatric service to the adult service a phased ‘transition’ service is offered.  This allows young adults to meet the Audiologists in the adult team and become familiar with Adult Audiology services, while still being supported by the Paediatric team. It helps young adults and their families know what to expect when they move into adult services. It helps the Adult service understand the young person’s needs and previous experiences within Audiology.  

6.4 School Screening Service  

When children are 4-5 years old they are offered a hearing screening test in school. This is done by a specially trained school screener. Any children who do not pass the screen are offered an assessment in Audiology for a full hearing test. This ensures hearing problems are picked up early and treated.  

6.5 Complex paediatric service  

For children who need a more flexible approach to their appointments, we have a special complex paediatric clinic. There are a wider range of tests available and specially trained staff who can adapt the hearing assessment and rehab to suit each child. Children in this clinic are monitored routinely and see the same member of staff at each visit.

Newborn Hearing Screening Service  

Auditory Brainstem Response Test (ABR) 

The test is usually for newborn babies referred from the Newborn Hearing Screening Programme. The appointment will usually take about one to two hours. This includes time to settle your baby. The tests will not hurt or be uncomfortable for your baby. You will be able to stay with your baby while the tests are done. You may want to take a partner or friend or relative with you to the appointment.  

The test involves small sensors being placed on your baby’s head. This is called the Auditory Brainstem Response (ABR) test. Headphones are placed over your baby’s ears or in your baby’s ears and a series of clicking sounds are played. A computer measures how well your baby’s ears respond to sound 

If your baby is found to have a hearing loss, the diagnosis will be discussed in full along with options to help your baby hear and communicate.  

Information on Newborn Hearing Screening can be found here: Newborn hearing screening - NHS (www.nhs.uk) 

Balance Service

The Balance Service is fully equipped with up-to-date specialist equipment to perform the following vestibular/balance function tests: 

• Videonystagmography (VNG) – a test of central balance function which involves monitoring eye movements with cameras fitted inside a pair of special goggles. 

• Electronystagmography (ENG) – an alternative test of central balance function which involves monitoring eye movements through electrodes placed on the face. 

• Electrocochleography (ECochG) – this is performed when Meniere’s Disease is suspected. Please see link to our Meniere’s Disease factsheet 

• Bi-thermal water and air caloric testing – a test of peripheral balance function which involves putting water/air into the ears. 

• Positional testing, including the Dix Hallpike Manoeuvre when Benign Paroxysmal Positional Vertigo (BPPV) is suspected. Please see link to our BPPV factsheet 

The Balance Service also offers customised balance rehabilitation programmes for patients who are suffering with dizziness and has established links with the Falls Service and the Physiotherapy Service.  Every week, there is a joint Audiologist-Physiotherapist clinic in order to provide those patients who have complex dizziness problems with more specialised assessment and rehabilitation. Access to the Salford Audiology Balance Service is normally via a referral from an ENT (Ear, nose and throat) doctor or a GP.   If you already have an appointment with the Balance Service, please see the link to our Labrinthitis Fact Sheet. 

More information can be found at    

• http://www.menieres.org.uk/  ​​​​​

• http://www.vestibular.org/