Hearing loss in adulthood is linked with greater unemployment, increased risk of poor health, depression and increased risk of other conditions including dementia. However, there is little recognition of the impact of hearing loss or of the latest hearing technologies which can improve hearing. Nowhere is the failure to address the consequences of hearing loss better exemplified than in the low provision of cochlear implantation for adults.

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This report reviews the current evidence on the impact of deafness in adulthood and the new evidence of the impact of cochlear implantation in adulthood since the review by NICE, and maps the provision of cochlear implantation in England in a changing health context. It also reports on new research exploring the experiences of adults who have been refused implantation.

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