Getting a hearing test – everything you need to know

If you're concerned you might have hearing loss and need hearing aids, it's wise to have a hearing test done.

Poor hearing can have a considerable impact on your wider health, as well as your social life – so don't put it off. 

If you want a free NHS hearing test, you'll need to be referred by your GP. That is, unless you live in an area where you can refer yourself (check with your GP surgery).  

Once this has been done, a qualified audiologist will carry out your assessment. You may also be referred to an ear, nose and throat (ENT) doctor for further investigation.

What is hearing loss? 

Hearing loss is a partial or total inability to hear and is the result of sound signals not reaching the brain. 

Warning signs that you might have hearing loss include:

• difficulty hearing people clearly, misinterpreting what they say
• perceiving others as mumbling, and asking them to repeat what they've said
• having the TV or radio turned up louder than other people need.

Hearing loss usually develops gradually as you get older, or as loud or continuous noise damages structures in the inner ear, especially the delicate hair cells and their connections, which can lead to permanent hearing loss. 

Sometimes, though, it can happen suddenly, which can come as a shock.

Types of hearing loss

There are three types of hearing loss: conductive, sensorineural and a combination of both.

Conductive hearing loss happens when sound waves can't get through the outer or middle ear to reach the inner ear. The cause is often temporary, due to an infection or a build-up of earwax.

Sensorineural hearing loss is a more permanent impairment, usually caused by ageing or exposure to loud noise.

Some conditions may require further medical investigation or treatment. Your GP will refer you to an ENT doctor if they're unable to treat it themselves.

What can I do about hearing loss? 

First, it's a good idea to visit your GP to rule out underlying causes, such as an infection or wax build-up. If your doctor then suggests a hearing test, you can either opt for a free NHS one or pay for a private test.

How to get an NHS hearing test

To get a free test and hearing aids on the NHS, you'll need a referral from your GP. Once you have this, you can see an audiologist at a hospital or clinic.

In some areas of England, you may also be able to choose to see a private company for your NHS audiology care under the Any Qualified Provider scheme (AQP). This allows you to choose from a list of high street chains, including Specsavers.

It's also possible to have a home visit, so if you're housebound, let your GP know.

How to get a private hearing test

If you’d rather pay for a hearing test, you can book an appointment directly with a private audiology clinic or some pharmacies and opticians – you don't need to talk to your GP first. 

However, check our hearing aid prices before buying one yourself, so you know what you're likely to pay and what extras to factor in.

How to get a free hearing check

For a quick hearing check, you can try the RNID free online hearing test – it takes just three minutes. Or take the Shoebox online test.

These checks are not the same as a full hearing test by an audiologist, but they're a good first step.

On the high street, hearing tests are done by companies such as Boots, Hidden Hearing, Scrivens and Specsavers, as well as by independents, as part of their audiology offering. Hearing tests are usually free at high-street providers, with no GP referral needed. However, hearing aids or further medical treatment require an NHS referral via your GP — or private payment. 

Find out more about buying hearing aids – NHS vs private hearing aid providers

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What happens during a hearing test? 

Tests usually take place in a soundproofed booth and include air-conduction testing. 

Sounds of different volumes and frequencies (low, middle and high) are played through headphones, and you press a handheld button when you hear them. 

The audiologist will gradually make the sounds softer, testing the quietest you can hear until they reach your ‘threshold’ of hearing at each frequency.

The test results will show the audiologist whether your hearing loss is likely to be conductive or sensorineural. More details will be explained to you, and you'll be asked some standard questions about your ears, general health, lifestyle and any other symptoms you've been experiencing.  

You can ask for a copy of your audiogram if you wish.

Seeing an audiologist virtually

Remote care and check-ups, which may be more convenient for some people, have been possible since Covid-19 made them a necessity.

The audiologist can even connect remotely to your hearing aids and make live adjustments, as if you were in the consultation room. The settings can then be saved into your hearing aids. 

If you're unable to visit in person, do ask about virtual appointments.

Do I need a hearing aid?

When you go for your hearing test, the audiologist will establish your levels of hearing, the type of hearing loss you might have and whether a hearing aid is a suitable option for you.

Some ear conditions may call for further medical investigation or treatment instead of – or as well as – hearing aids, which the audiologist will arrange. This may be the case if you experience dizziness or there's a significant difference in hearing between each ear.

If you have sensorineural hearing loss, the damage can’t be repaired, and hearing aids won’t be able to fully restore your hearing. But they can significantly improve your quality of life.

If hearing aids are an option for you and you’d like to go ahead, the audiologist will advise you on the best types of hearing aid to suit your hearing loss and lifestyle. 

Your audiologist will usually make an impression of your ear if you need an ear mould. You’ll need to return a few weeks later to have your hearing aid fitted.

Some types of hearing aid, called an open-ear fitting, don’t require an ear mould. These can sometimes be fitted on the same day as your test.

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What happens after my hearing test?

If you need hearing aids, you’ll go to a second appointment to have them fitted. You'll also be shown how to use them properly.

The hearing aids will be adjusted according to your levels of hearing, and you’ll be invited to attend a third appointment to discuss how you’re doing and resolve any problems.

Remember, it can take some time to get used to your hearing aids – usually between two and four weeks. If you’re still having problems after this time, book a follow-up chat with your audiologist.

How long do hearing aids last?

It's up to you how often you have your hearing assessed, but it's worthwhile booking an appointment with your audiologist every three to six months. This will help you maintain your hearing aids and get adjustments made if you feel you're not hearing so well. 

The NHS doesn't specify how regularly you should have a hearing test, and much depends on your age and health, but it's a good idea to see an audiologist every few years after the age of 50.

When you’re buying hearing aids privately, this comes at a cost, although most private suppliers will provide these appointments free of charge for at least the warranty of the hearing aids – usually two years. 

Before you buy anything, check with the audiologist or hearing-aid dispenser about their aftercare service. A good ongoing relationship is key, so make sure you check our guide to the best and worst hearing aid providers.

Hearing aids should typically last three to six years, so you’ll need to budget for buying new ones. You’ll also need to factor in the cost of replacing parts, such as batteries and wax traps, unless they're included in your plan.

It's likely that your hearing loss will change over time, although this is unpredictable. Usually, your hearing is quite stable and changes very little between one hearing test and the next. However, hearing aids are flexible enough to be adjusted to changes in your hearing level to make sure you get the best from them.

If you notice any significant deterioration, or if you feel your hearing aids have stopped working as well as they used to, seek advice from your audiologist. They should be able to identify the cause of the issue and get your hearing aids working properly again.

For more advice, check our guide to getting used to hearing aids.

Worried about your eyesight too? Find out more about the best places to have an eye test