Intended for healthcare professionals

Practice Practice Pointer

How to communicate with patients who are D/deaf or have hearing loss

BMJ 2021; 373 doi: (Published 09 June 2021) Cite this as: BMJ 2021;373:n1382
  1. Helen Grote, consultant neurologist1,
  2. Fatin Izagaren, paediatric emergency medicine ST62,
  3. Vicky O’Brien, GP partner3
  1. 1Chelsea and Westminster Hospital NHS Foundation Trust, London SW10 9NH, UK
  2. 2Guys’ and St. Thomas’ NHS Foundation Trust, London, UK
  3. 3Summercroft Surgery, Farnborough, UK
  4. Correspondence to: H Grote

What you need to know

  • Asking, “How can I help you hear and communicate?” ensures that patients are fully involved in decisions about their care

  • A Deaf person who uses British Sign Language (BSL) has a legal right to services in their own language. Support D/deaf people in using their preferred method of communication in line with relevant legislation such as the Equality Act (2010). This applies to face-to-face and remote consultations

  • Registered, qualified interpreters should be booked in advance of appointment. Video interpreting services are also available

In the UK, around 1 in 7 people have hearing loss, rising to 1 in 2 of those aged over 70 years.1 Data from the World Health Organisation indicates that in 2018, 466 million people (6.1% of the world’s population) had hearing loss; a figure expected to rise to 630 million by 2030.2 D/deaf (see box 1 for note on terminology) patients have a variable presentation, ranging from mild difficulties understanding speech in noisy environments through to little or no speech recognition. In England and Wales, an estimated 900 000 people are severely or profoundly D/deaf, of whom approximately 70 000 use British Sign Language (BSL) as their first language.3 The World Federation for the Deaf estimates that globally, there are 72 million deaf people using more than 300 different sign languages, of whom more than 80% of these individuals live in developing countries.4

Box 1

Terminology, identity, and language around hearing loss

The term “D/deaf” is used throughout this article. “Deaf” refers to patients who primarily use sign language and identify with Deaf culture and the Deaf community, whereas “deaf” refers to those who primarily use spoken English (or their native spoken language). Patients in either group may use hearing aids or cochlear implants. The term “hard of hearing” is used by a wide range of patients; including older adults and those with …

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