BAA Board Condemns Upselling Practices by some NHS Hearing Aid Providers

The British Academy of Audiology (BAA) Board is deeply concerned by findings in the RNID Research Note, which confirms that nearly a quarter of NHS hearing aid patients at high street providers are subject to upselling. While disheartening, this aligns with anecdotal reports BAA has received.

The RNID report Investigating Variation in NHS Hearing Aid Services, reveals that 23% of respondents were encouraged to consider private hearing aids during NHS appointments —a practice in direct violation of NHS National Guidance. This guidance prohibits discussing or promoting private options during NHS consultations.

Although the full extent of this unethical behaviour remains unclear, BAA highlights the lack of mechanisms to detect and prevent it. Until such safeguards are in place, BAA strongly advises against expanding private provision of NHS services.

Commitment to Free and Accessible Audiology Services
BAA reaffirms its commitment to free, equitable audiology services, as outlined in its 2024 Position Statement, The Future of NHS Adult Hearing Loss Management. The RNID report exposes how some providers maybe misusing their Any Qualified Provider (AQP) status to undermine NHS trust by portraying NHS hearing technology as outdated and pushing private alternatives.

BAA, through its Audiology Supplies Group (ASG), ensures NHS hearing aid technology meets stringent standards. For example, wireless functionality has been a requirement in all new NHS Hearing Devices accepted onto the NHS Supply Chain hearing aids since 2022, although this technology option has been available on products through NHS procurement for many years.

Advocating for Quality Standards
Quality should never be optional. BAA consistently champions the implementation of robust Quality Standards across audiology services. The New Adult Quality Standards currently under consultation represent a UK-wide effort to establish minimum benchmarks that can be audited for compliance. These standards are a product of collaboration across the four home nations and reflect shared professional values. Other quality output from BAA includes publishing Paediatric Quality Standards and a Quality Improvement Toolkit, and providing the Starting from Zero series for quality process guidance. BAA supports RNID’s call for national quality standards to ensure consistent care across providers.

Self-Referral Challenges
While some NHS departments offer self-referral options, complex commissioning and pathway arrangements delay broader adoption. BAA shares best practices to encourage implementation, but urges caution against expanding self-referral options to private providers without addressing ethical concerns raised in the RNID report.

President’s Statement
BAA President Claire Benton expressed alarm over upselling practices: “I am deeply concerned to read in the RNID report that some NHS patients are being upsold when they should receive high-quality NHS hearing care free at the point of delivery. BAA supports NHS Supply Chain in setting the standard for product specification and quality, but some providers are clearly falling short. In my head of service role, I was proud to deliver excellent hearing technology through NHS Supply Chain procurement. There is no reason why this should not be the standard for all.”

BAA shares RNID’s concerns about the potential risks of expanding access to high street services while upselling practices persist. The BAA strongly opposes outsourcing paediatric services to private providers, citing serious concerns about such developments in some areas.

Call to Action
The BAA urges governments and commissioners to review the findings in the RNID Research Note, alongside the BAA Position Statement: The Future of NHS Adult Hearing Loss Management. Policymakers must ensure that NHS patients can access high-quality hearing services free of charge, and without undue pressure or upselling.

Because the sample size is small, RNID calls for further research. BAA agrees with this, but we also believe that nobody – not a single person – should feel pressured into purchasing private healthcare by their NHS provider.

Please note: the RNID Research Note and BAA comment refer to services provided in England.

Download the RNID report here: RNID Research Note: Investigating Variation in NHS Hearing Aid Services

Read the RNID Commentary: Investigating Variation in NHS Hearing Aid Services webpage

Download the BAA release here: BAA Press Release