Digital hearing aids
About this factsheet
This factsheet is part of RNID’s hearing aids range. It is written for deaf
and hard of hearing people who would like to find out more about digital
hearing aids.
This factsheet covers:

How digital hearing aids work.

Their advantages when compared to traditional analogue hearing
aids.

Digital hearing aids on the NHS.

How to buy them privately.
At the end of this factsheet we give you details of organisations you can
contact for further information.
If you would like this factsheet on audio tape, in braille or in large print,
fill in the Want to know more? form at the end of this factsheet and send
it to RNID.
How do analogue hearing aids work?
Analogue hearing aids have a microphone that picks up sound and
converts the sound to small electrical signals. These signals vary
according to the pattern of the sound. The signals are then amplified
(made louder) by transistors and fed to the earphone on the hearing aid
so that the person using the aid can hear them.
Digital hearing aids, RNID Information, February 2003 2
Most of the better analogue hearing aids compress the sound using
‘automatic gain control’ (AGC). This amplifies quiet sounds until they are
loud enough to be heard, but gives less amplification to sounds that are
already loud, so that the person using the hearing aid is protected
against uncomfortably loud sound levels. Analogue hearing aids are
generally not as flexible as digital aids, but they are the cheapest
hearing aids available.
How do digital hearing aids work?
Digital aids work in a different way. They take the signal from the
microphone and convert it into ‘bits’ of data – numbers that can be
manipulated by a tiny computer in the hearing aid. This makes it
possible to tailor and process sounds very precisely, in ways that are
impossible with analogue aids. The better digital aids can be very finely
adjusted to suit individuals. Many even adjust themselves automatically
to suit different sound environments.
Cutting out background noise
When someone talks to you, you usually want to hear what they are
saying, rather than whatever noise is going on in the background.
People who use traditional analogue hearing aids often complain that
they find it difficult or impossible to follow conversation in noisy places.
Many digital aids are designed to reduce steady kinds of background
noise such as the rumble of traffic or the whirr of a fan. This makes
listening more comfortable. However, it does not necessarily help you to
pick out a single voice from everything else that is going on, especially
when several people are talking.
Two things have been shown to improve hearing in noisy situations
more than anything else – wearing hearing aids in both ears, and using
hearing aids that have twin microphones.
Digital hearing aids, RNID Information, February 2003 3
What are twin microphones?
‘Twin’ or ‘dual’ microphones are a type of directional microphone that
work effectively in hearing aids. The twin microphone picks up sounds
that come from in front of you much better than sounds to the side or
behind you, making it easier for you to focus on what you want to listen
to in a noisy place. Some – but not all – digital hearing aids have twin
microphones. You can also switch settings on some aids. This is ideal
when you want to switch to ‘all round sound’ when you need to, for
example, when you are crossing the road.
Some sophisticated analogue hearing aids have twin microphones, but
digital hearing aids can increase the directional effect of twin
microphones.
Can digital aids help reduce whistling?
Yes. Some digital hearing aids have ‘acoustic feedback suppression’ or
– better still – ‘feedback cancellation’. This means that they can
automatically reduce the whistling that bothers many people who use
hearing aids.
More comfortable listening
Many digital hearing aids have a feature called ‘wide dynamic range
compression’ that can be adjusted separately in each of several ‘bands’
or ‘channels’. It means the aid can be programmed to suit your
particular hearing loss and ensures that you always hear different
sounds at levels that are comfortable for you. This type of aid is often
completely self-adjusting. The aid will only work well for you if the
person who fits it adjusts its settings carefully in the first place. Some
fine-tuning may be needed when you have become used to the aid.
Digital hearing aids, RNID Information, February 2003 4
Some types of analogue aid can also be programmed to suit individual
users but the way loudness is controlled in these aids is less
sophisticated than in multi channel digital aids. These types of aid may
not always give as comfortable listening as digital aids.
What is the ‘T’ switch?
As with all NHS analogue aids it is generally possible to switch to ‘T’
with a digital hearing aid. This allows you to pick up sound from a loop
system or inductive coupler. However, if you choose a very small style
of analogue or digital aid that fits into your ear canal there may not be
room for a telecoil and so you will not have the ‘T’ option.
What size are digital hearing aids?
Digital hearing aids – just like analogue ones – come in ‘behind-the-ear’,
‘in-the-ear’ or ‘in-the-canal’ models. They are not necessarily smaller
than analogue hearing aids. You may be offered a choice but remember
that the very small styles, though less noticeable, may be more fiddly to
use, tend to break down more often and you may not be able to use
them with a loop system.
Digital hearing aids on the NHS
RNID has campaigned long and hard for modernisation of the NHS
hearing aid service. In January 2000 the Government announced that it
would fund a project to upgrade the service and introduce high quality
digital hearing aid technology.
The NHS is the largest buyer of hearing aids in the world and can use
this purchasing power to obtain high quality digital aids in bulk and at
greatly reduced prices. It provides these free of charge as with
traditional analogue NHS hearing aids.
Digital hearing aids, RNID Information, February 2003 5
The upgrade of the NHS hearing aid service in England
In September 2000 the first of 20 selected NHS trusts in England began
to provide digital aids as part of the ‘First wave’ project.
The Department of Health asked RNID to manage the work to make
sure that audiology departments were ready to provide the new service.
These departments required additional equipment and training, and
most needed extra staff to deliver the modernised service.
An independent evaluation of the ‘First wave’ showed that people were
benefiting more from the new digital hearing aids than they had from the
old analogue NHS hearing aids provided by the traditional service. They
were also using their hearing aids for more of the time in different
situations.
50,000 RNID supporters campaigned with us for the modernisation to
be extended throughout the NHS. On 24 December, 2001, the Health
Minister announced an additional £20 million to modernise hearing aid
services in 46 more NHS Trusts during 2002. They will all have started
fitting digital hearing aids by April 2003. You will find them listed in the
table at the end of this factsheet.
In February 2003, the Health Minister announced a further £94 million to
complete the modernisation programme, bringing the new digital
hearing aid service to all remaining audiology departments in England
by April 2005.
Many services are keen to modernise as soon as possible. But in some
areas the local funding organisations – Primary Care Trusts – are not
giving them the support they need to join the programme quickly.
Digital hearing aids, RNID Information, February 2003 6
What sort of digital hearing aids are available on the NHS?
Both moderate-power and high-power digital hearing aids are available
for adults and children. They are sophisticated multi-channel aids with
features such as directional microphones and automatic noise
reduction. The NHS is able to buy them much more cheaply than the
£2,000 it would cost you to buy them privately.
Who can qualify for a digital aid?
If you have not had an NHS hearing aid before you must go to your GP
to be referred. The audiology departments that have now been
modernised are offering digital hearing aids to every patient waiting for
their first hearing aid if their hearing tests show that they would benefit
from one. You may be offered two digital hearings aids, one for each
ear. If so, it is worth trying because many people benefit more from an
aid in each ear than from just one.
If you are a war pensioner you will be given priority for hearing aids if
your pension was awarded for deafness resulting from service. This
means that you may be seen more quickly at your clinic but it does not
mean that you are entitled to better hearing aids than other patients
receive. If your local clinic is already part of the modernisation
programme you will probably be able to try digital hearing aids.
You can get an NHS digital hearing aid even if you have already bought
a hearing aid privately. If you are a private ear, nose and throat (ENT)
patient you must wait the same amount of time to be fitted with an aid
as NHS patients referred by their GP. You will not be given any priority
over other referrals.
Digital hearing aids, RNID Information, February 2003 7
Who will not be eligible for a digital aid?
You will generally not be eligible to get digital aids if you have been
fitted with a new hearing aid within the last three years, unless your
hearing has got significantly worse since then. If you already have an
NHS hearing aid you should wait to be invited for a review appointment,
unless you are having real difficulties with your aid or you think that your
hearing has got worse, in which case you should ask for an
appointment.
If you are an overseas patient, as defined by the NHS rules, you will not
generally be eligible to be fitted with digital aids.
It is very unlikely that hospitals will accept patients from outside the
areas they normally provide a service for. Many already have long
waiting lists and demand is increasing all the time.
Follow-up service on the NHS
You will be given a follow-up appointment if you get digital aids on the
NHS. Batteries and hearing aid repairs will be available free of charge.
NHS hearing aids remain Government property so they cannot be
insured on your household policy, and should be returned to the
audiology department if you no longer need them. If you lose or damage
a digital hearing aid you may, in some circumstances, be charged or
have to accept a non-digital – analogue – aid as a replacement.
The upgrade of the NHS hearing aid service in Northern
Ireland
The Northern Ireland Minister has pledged £2.5 million to modernise
audiology services by March 2004. This will be used to equip and train
Digital hearing aids, RNID Information, February 2003 8
audiology staff and to supply departments with digital hearing aids so
that they can begin to provide these to patients by September 2003.
The upgrade of the NHS hearing aid service in Scotland
In February 2003 the Scottish Executive announced an investment of £8
million over four years to modernise audiology services. This was on top
of the £2.25 million funding that they had already provided to upgrade
audiology equipment.
The upgrade of the NHS hearing aid service in Wales
The Welsh Executive has provided £2.25 million to help modernise
audiology services and hearing aids throughout Wales. Local funding
was also provided and all departments are now delivering the new
service.
Can I buy digital aids privately?
Yes, It is possible to buy digital hearing aids from high street dispensers,
but the cost of private purchase is very high – up to £2500 for each aid.
If you choose to buy privately, you will want to be sure that what you are
getting is right for you. Ask the dispenser for a 28-day money-back
guarantee so that you can try the hearing aid out properly in plenty of
different situations, before committing yourself.
See the RNID factsheet Buying a hearing aid? for more information.
Buying abroad
Some people have bought digital hearing aids on the Continent, where
they are much cheaper. If you decide to buy abroad you should be
aware of potential problems. The main concern is lack of follow-up and
after-care. People often take weeks to get used to new hearing aids.
Digital hearing aids, RNID Information, February 2003 9
You may need further fine-tuning of your hearing aid in order to get the
most from it. It is important to check beforehand what will happen if you
need more help or if your aid breaks down once you are back home
again.
Further information
Visit www.mhas.info for the latest information about Modernising
Hearing Aid Services (MHAS).
Further information from RNID
If you want to find out more about some of the subjects covered in this
factsheet you may find our factsheets Buying a hearing aid? and The
NHS hearing aid service useful. You may also want to look at our leaflet
All about hearing aids.
The RNID Information Line offers a wide range of information on many
aspects of deafness and hearing loss. You can contact us for further
copies of this factsheet and the full range of our information factsheets
and leaflets.
RNID Information Line
RNID Information Line, 19-23 Featherstone Street, London EC1Y 8SL.
Tel: 0808 808 0123. Textphone: 0808 808 9000. Fax: 020 7296 8199.
E-mail: informationline@rnid.org.uk Website: www.rnid.org.uk
Alternatively, fill in the Want to know more? order form at the end of this
factsheet and return it to RNID.
Digital hearing aids, RNID Information, February 2003 10
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RNID Information, February 2003
Digital hearing aids, RNID Information, February 2003 11
The trusts in England that will be modernised and providing digital
hearing aids by April 2003
Trust name Hospital Fitting
Addenbrooke’s NHS
Trust
Addenbrooke’s
Hospital, Cambridge
Adults and children
Barking, Havering and
Redbridge NHS Trust
Oldchurch Hospital,
The Willows, St
George’s Hospital
Adults and children
Basildon and Thurrock
General Hospitals
NHS Trust
Basildon and Thurrock
Hospital
Adults and children
Birmingham
Children’s Hospital
NHS Trust
Birmingham Children’s
Hospital
Children
Birmingham
Heartlands Hospital
NHS Trust
Yardley Green Hospital Adults and children
Bolton Hospital NHS
Trust
Bolton Primary Care
Trust
Royal Bolton Hospital
Children’s Hearing
Assessment Centre,
Halliwell
Adults and children
Bournemouth Primary
Care Trust
East Dorset Audiology
Service
Adults and children
Bradford Hospitals
NHS Trust
Bradford Royal
Infirmary
Adults and children
Brighton Healthcare
NHS Trust
Royal Sussex County
Hospital
Adults and children
Digital hearing aids, RNID Information, February 2003 12
The trusts in England that will be modernised and providing digital
hearing aids by April 2003
Trust name Hospital Fitting
Central Manchester
and Manchester
Children’s University
NHS Trust
Manchester Royal
Infirmary
Adults and children
Central Manchester
Primary Care Trust
Moss Side Health Centre Children
City Hospital
Sunderland NHS
Trust
Sunderland Royal
Hospital
Adults and children
Countess of Chester
Hospital NHS Trust
Countess of Chester
Hospital
Adults and children
Croydon and Surrey
Downs Community
NHS Trust
The Crystal Centre Children
East Cheshire NHS
Trust
Macclesfield District
General
Adults and children
East Sussex Hospitals
NHS Trust
Conquest Hospital,
Eastbourne Hospital
Adults and children
Essex Rivers
Healthcare Trust
Essex County Hospital Adults and children
George Eliot Hospital
NHS Trust
George Eliot Hospital
Nuneaton
Adults and children
Gloucestershire
Hospitals NHS Trust
Gloucestershire Royal
Hospital
Adults and children
Great Ormond Street
Hospital NHS Trust
Great Ormond Street
Hospital
Children
Digital hearing aids, RNID Information, February 2003 13
The trusts in England that will be modernised and providing digital
hearing aids by April 2003
Trust name Hospital Fitting
Hammersmith Hospitals
NHS Trust
Charing Cross Hospital Adults and children
James Paget Healthcare
NHS Trust
James Paget Hospital,
Great Yarmouth
Adults and children
Leeds Teaching
Hospitals NHS Trust
Leeds General
Infirmary
Adults and children
Maidstone and
Tunbridge Wells NHS
Trust
Preston Hall Hospital Children
Mayday Healthcare NHS
Trust, Croydon
Mayday University
Hospital,
Adults
Mid Cheshire Healthcare
NHS Trust
Leighton Hospital Adults and children
Morecambe Bay
Hospitals NHS Trust
Furness General
Hospital, Westmorland
General Hospital,
Royal Lancaster
Infirmary
Adults
North Cheshire Hospitals
NHS Trust
Warrington Hospital Adults and children
North Devon Healthcare
NHS Trust
North Devon District
Hospital
Adults and children
North Hampshire NHS
Trust
North Hampshire
Hospital
Adults and children
North West London
Hospitals NHS Trust
Central Middlesex
Hospital; Northwick
Park Hospital
Adults and children
Digital hearing aids, RNID Information, February 2003 14
The trusts in England that will be modernised and providing digital
hearing aids by April 2003
Trust name Hospital Fitting
Pennine Acute Hospitals
NHS Trust
North Manchester
General Hospital
Adults and children
Peterborough Hospitals
NHS Trust
Edith Cavell Hospital Adults and children
Queens Medical Centre
University NHS Trust
Nottingham
Hearing Services
Centre and Children’s
Hearing Assessment
Centre, Ropewalk
House, Nottingham
Adults and children
Rochdale NHS Trust
(now called Pennine
NHS Trust)
Birch Hill Hospital Adults and children
Royal Berkshire and
Battle Hospitals NHS
Trust
Royal Berkshire
Hospital, Reading
Adults and children
Royal Cornwall Hospitals
NHS Trust
Royal Cornwall
Hospital, Truro
Adults
Royal Devon & Exeter
Healthcare NHS Trust
Royal Devon and
Exeter Hospital
Adults and children
Royal Free Hampstead
NHS Trust
Royal National Throat,
Nose and Ear Hospital,
London; Royal Free
Hospital, Hampstead
Nuffield Hearing and
Speech Centre, Gray’s
Inn Road
Adults and children
Digital hearing aids, RNID Information, February 2003 15
The trusts in England that will be modernised and providing digital
hearing aids by April 2003
Trust name Hospital Fitting
Royal Liverpool and
Broadgreen University
Hospitals NHS Trust
Royal Liverpool
University Hospital
Adults
Royal Shrewsbury and
Princess Royal Hospitals
NHS Trusts
Royal Shrewsbury and
Princess Royal
Hospitals
Adults and children
Royal United Hospital
Bath NHS Trust
Royal United Hospital
Bath
Adults
Salford Primary Care
Trust
Hope Hospital and
Eccles Health Centre
Adults and children
Sandwell and West
Birmingham Hospitals
NHS Trust
Hearing Services
Centre, Western Road
Adults and children
Sheffield Children’s
Hospital NHS Trust
Sheffield Children’s
Hospital
Children
Sheffield Teaching
Hospitals NHS Trust
Royal Hallamshire
Hospital
Adults
Sherwood Forest
Hospitals NHS Trust
Kings Mill Centre;
Newark General
Hospital
Adults and children
South Manchester
University Hospitals NHS
Trust
Withington Hospital Adults
Southampton University
Hospitals NHS Trust
Royal South Hants
Hospital
Adults and children
Digital hearing aids, RNID Information, February 2003 16
The trusts in England that will be modernised and providing digital
hearing aids by April 2003
Trust name Hospital Fitting
Southport and Ormskirk
Hospital NHS Trust
Ormskirk and District
General Hospital
Adults
St Helens and Knowsley
Hospitals NHS Trust
St Helens Hospital Adults
Surrey and Sussex
Healthcare NHS Trust
Crawley Hospital Adults and children
Swindon and
Marlborough NHS Trust
Princess Margaret
Hospital
Adults and children
Tameside and Glossop
Acute Services NHS
Trust
Tameside General
Hospital
Adults and children
Trafford Healthcare NHS
Trust
Trafford General
Hospital, Manchester
Hearing Assessment
Centre for Children,
Timperley Health
Centre
Adults
Children
United Bristol Healthcare
NHS Trust
Bristol Children’s
Hospital
Children
University Hospital
Birmingham NHS Trust
Selly Oak Hospital Adults
University Hospitals of
Leicester NHS Trust
Leicester Royal
Infirmary
Adults and children
West Dorset General
Hospitals NHS Trust
Dorset County Hospital Adults and children
West Suffolk Hospitals
NHS Trust
West Suffolk Hospital Adults and children
Digital hearing aids, RNID Information, February 2003 17
The trusts in England that will be modernised and providing digital
hearing aids by April 2003
Trust name Hospital Fitting
Whipps Cross University
Hospital NHS Trust
Whipps Cross
Hospital, London
Adults and children
Winchester and
Eastleigh Healthcare
NHS Trust
Royal Hampshire
County Hospital,
Winchester
Adults
Windsor and
Maidenhead Primary
Care Trust
King Edward VII
Hospital, Windsor
Adults and children
Wirral Hospital NHS
Trust
Arrowe Park Hospital,
Child Development
Centre, Clatterbridge
Hospital
Adults and children
Wolverhampton
Healthcare NHS Trust
West Park Hospital;
Red Hill Street Clinic
Adults and children
Wrightington, Wigan and
Leigh NHS Trust
Thomas Linacre
Centre
Children’s Hearing
Service, Jack Ashley
Centre
Adults
Children
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