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We have compiled a comprehensive list of the questions that we get asked on a regular basis. They cover a broad spectrum of topics around the hearing test, hearing loss, hearing technology, and our services.

How many people suffer from hearing loss?

In the UK, it is estimated that more than 11 million people, or one in six of the population, suffer from some level of hearing loss – so you’re definitely not alone.

If you’re concerned about your hearing, or the hearing of a loved one, get in touch for a free, no obligation hearing test.

What is an RHAD?

A Registered Hearing Aid Dispenser (RHAD) is an audiologist who works in a private practice. They conduct the hearing test, fit hearing aids, and provide aftercare to their patients. They are regulated by the Health and Care Professions Council (HCPC).

How much do your hearing aids cost?

We offer the very latest in hearing technology, from all of the leading manufacturers. This means that we can always find a solution to suit any budget, and can often compete against the high street chains.

Our hearing aids start from as little as £XXX which includes all fitting and unlimited aftercare services.

First of all we will chat through the issues you have been facing that have led you to seek a hearing test. This allows us to paint a picture of your lifestyle and the main environments and situations in which you notice the effects of your hearing loss.

We will then thoroughly examine the outer part of your ears using an instrument called an otoscope. This is a completely painless procedure that allows us to check if there are any obstructions, such as wax, which are preventing sound from reaching your ear drum. We are also fully trained to recognise symptoms of any conditions that would require a referral to your GP or an ENT consultant.

Next, we will conduct a Pure Tone Audiometry (PTA) hearing test. PTA is used to assess any decline in sensitivity to sound and it involves listening through headphones to a wide series of tones, which are played at different frequencies and volumes. How well you hear these tones will be plotted on a graph called an audiogram which tells us about your particular hearing loss and what we need to recommend to correct it.

An audiogram is plotted during your hearing test

Once we have all the information we need from the hearing test, we can talk about your options and show you the wide range of solutions that we believe will best suit your needs, lifestyle, and budget.

Modern hearing aids are simply incredible. Multiple microphones, a loudspeaker and numerous digital signal processors can be fit into the tiniest, most discrete devices. The most significant advancement of recent years was the use of digital amplifiers as this led to the miniaturisation of key components. Today, even severe hearing losses can be helped by imperceptible hearing aids that are tailor-made to fit the specific contours of the ear canal.

They come in a wide variety of shapes and sizes, and we are often asked, “which is the right hearing aid for me?” The answer we give is that the right hearing aid for you is the one that is appropriate for your particular hearing loss, your lifestyle, and that you are comfortable using.

We can chat through all of your available options once we have completed the initial, free of charge hearing test and established a short list that would suit your individual requirements.

There are two main causes of hearing loss.

Conductive hearing loss results from diseases or disorders that limit the transmission of sound through the outer or middle ear.

Conductive hearing loss can be detected during the hearing test

Sensorineural hearing loss is caused by damage to the fine nerve endings inside the cochlea. The result is a reduced perception of sound intensity and quality. This is by far the most common type and is mainly caused by the passage of time; consequently, it is usually referred to as ‘age induced’ hearing loss.

Sensorineural hearing loss is picked up by a hearing test.

Just as with our eyesight, our hearing becomes less effective as we age. This type of hearing loss cannot be reversed and, left untreated, can lead to a multitude of other problems. Research tells us that people with untreated hearing loss begin to opt out of conversations because they cannot keep up with what is being said. Consequently, relationships can suffer and work can become challenging. Eventually the person becomes socially isolated, frustrated, and even depressed.

Age induced hearing loss usually occurs gradually, so you may not immediately notice that your hearing has deteriorated. There are certain signs to look for in yourself, and your loved ones, that could indicate that your sense of hearing is on the decline:

  • Other people sound as though they are mumbling when talking to you
  • The TV volume is louder than before
  • You can hear people talking but cannot understand all the words
  • You find it harder to follow conversations in noisy environments
  • You struggle to hear on the telephone

Even though the lost hearing can never be restored, today’s hearing instruments can dramatically improve quality of life for the wearer and their families. The only way to know for sure if your hearing could benefit from technical help is to have a hearing test.

Hearing loss is often described as either mild, moderate, severe or profound.

Mild hearing losses can be measured with a hearing test but are usually only noticed by the person in very specific situations. They will be able to hear unaided in most environments.

Moderate hearing loss is by far the most common type, observed by the affected person in many situations on a daily basis. They may still be able to hear without a hearing aid if they concentrate and the speaker is clear and face-on. However, the use of a discrete hearing aid would allow them to go about their life without relying on others to make allowances for their loss.

Severe hearing losses affect the person in most, if not all, circumstances. They can only hear without a hearing aid if they concentrate really hard, the speaker significantly raises their voice, and there are no competing background noises. Often the person still can’t hear everything that’s being said, even if the speaker is loud and very clear. This degree of hearing problem can be very debilitating without the correct technical assistance.

With profound hearing loss, the affected person cannot manage in any situation without a powerful hearing instrument. These hearing difficulties often also require Assistive Listening Devices (ALDs) to be used, such as vibrating or flashing doorbells, or type-talk phone services.

We offer the very latest in hearing technology, from all of the leading manufacturers, with whom we have close, long-standing relationships. This means that we can always find a solution to suit any budget, and can often compete against the high street chains.

Our hearing aids start from as little as £XXX which includes all fitting and aftercare services.

Our aids are also supplied on a 30 day trial period, with a no quibble satisfaction guarantee – or you simply return them without charge!

Please be advised that some severe cases of hearing loss are not suitable for digital prescriptions.

Tinnitus is the perception of noise that has no external source. It isn’t a disease or an illness; it is a symptom manifested within the auditory system. The noise may be perceived in one ear, both ears, or in the head, and it may be low, medium or high pitched. There may be a single noise or multiple noises, and it may fluctuate, or be permanently present. Temporary tinnitus is very common across all age groups, especially after short exposure to loud noise; but about 10% of the UK adult population has permanent tinnitus.

We still don’t know all of the causes of tinnitus, but it is most commonly associated with:

Age induced hearing loss. The number of fragile hair cells in the inner ear will decline over time due to wear and tear, causing hearing loss. This change makes any existing tinnitus more conspicuous as it is no longer disguised by external sound.

Loud noise. The hair cells of the inner ear can also be damaged by long-term exposure to loud noise, which can bring about tinnitus.

Infection. Middle ear infections can cause hearing loss and tinnitus which will be temporary in the majority of cases, but it is important to have the infection treated to avoid any long-term damage.

Stress and anxiety. It isn’t known if stress actually causes tinnitus, but it may become more noticeable when you are anxious or stressed.

To learn more about tinnitus you can visit the website of the British Tinnitus Association who offer some fantastic further reading.

If your sleep is impaired, it may be that the move from a noisy daytime environment to the quietness of the bedroom is making your tinnitus more noticeable. Some people find having low level background sounds can help disguise tinnitus. This is often referred to as sound therapy.

If your tinnitus is accompanied by any hearing loss, then trying to correct this loss with hearing aids is often very helpful. Modern hearing aids can come equipped with a sound generator, commonly referred to as a tinnitus masker. In addition to amplifying sounds, the aid provides extra low level sounds to help the habituation process (getting used to the tinnitus sound).

Cognitive Behavioural Therapy (CBT) can be useful for some people, either when used standalone or when combined with sound therapy.

Exercise helps the body achieve a higher level of well-being and, in some cases can help people to ignore and cope with their tinnitus more easily, as well as helping them to sleep better.

Sometimes, simply educating yourself about the condition can make you feel better about it. Knowing that it is very common and that you are not alone can be very reassuring. There’s plenty of great information and reading offered by the British Tinnitus Association to find out everything you need to know. Alternatively, we can have a chat about any concerns you might have about tinnitus during your consultation.

We take our hearing for granted, only realising how amazing the ability to hear is once it becomes impaired. The way that the human ear collects and interprets sound is the result of a complex but very delicate structure. If we take good care of our hearing, it will serve us better for longer.

Granted, it’s difficult to prevent all age related wear and tear, but you can protect your hearing against further damage by wearing ear defenders when you are exposed to intense or prolonged noise. Ear defenders or plugs can easily be bought over the counter and, when used correctly, will offer decent protection. The problem for most people it that they block out all sound; so if you are in a noisy environment but still need to hear what it is going on around you, we can have bespoke ear protection made for you to suit your particular circumstances.

If you listen to a lot of music using ear-buds or headphones, you can damage your hearing over time if you listen with the volume turned up too high. You may not be aware how loud your music is if you usually listen in noisy environments such as on the train. In these situations, noise cancelling headphones can be particularly useful to help you lower the volume.

If your hearing test shows you have hearing loss in both ears then we will advise that you wear two hearing aids (a binaural fitting) rather than just one (a monaural fitting). Ultimately, the decision-maker is you, but it is important that you be given the chance to experience binaural hearing aid amplification before a decision is made. Let us share with you a few reasons why two hearing aids are better than one.

Understanding of speech. With a binaural fitting, selective listening is more easily achieved. This means your brain can focus on the conversation you want to hear. Research shows that people understand speech and conversation significantly better when wearing two hearing aids.

Understanding in group and noisy situations. Speech intelligibility is improved in difficult listening situations when wearing two hearing aids.

Ability to tell the direction of sound. This is called localisation and it allows you to hear which direction someone is speaking to you from. It also helps you determine which direction traffic is coming from, or where your children/grandchildren are playing.

Better sound quality. When you listen to a stereo system, you use both speakers to get the smoothest, sharpest, most natural sound quality. By wearing two hearing aids, you increase your hearing range from 180 degrees reception with just one instrument, to 360 degrees.

Smoother tone quality. Binaural fittings require less volume which results in less distortion and better reproduction of amplified sounds.

Wider hearing range. You can hear sounds from a further distance with both ears, rather than just one.

Better sound identification. Often, with a monaural fitting, many noises and words sound alike; with two hearing aids sounds are more easily distinguishable.

Less hearing loss deterioration. Research shows that when only one hearing aid is worn, the unaided ear can lose its ability to hear over time. This is clinically referred to as the ‘auditory deprivation effect’. A binaural fitting keeps both ears equally active.

Hearing is less tiring. Not needing to strain to hear with the better ear makes participating in conversations easier and less exhausting.

Reduced feedback and whistling. With a lower volume control setting the chances of feedback is reduced.

Tinnitus Masking. If a person with tinnitus wears a hearing aid in only one ear, there will still be ringing in the ear that is unaided.

Just as you use both eyes to see clearly, you need both ears to hear clearly. Before you decide on one hearing aid, try two.

This depends on where you live. We know of at least one area in the country, North Staffordshire, where GPs aren’t investing money in hearing aids for patients with mild hearing loss.

One of the other cost cutting measures being undertaken is to only offer one hearing aid. The question above provides reasons why this might not be the best solution for a lot of patients.

Another consideration for some patients is the waiting time between follow up appointments. We’ve heard numerous tales from customers where they’ve become frustrated with their aids as they’ve had to wait weeks just to get a simple volume adjustment. Unfortunately, these frustrations can often lead to hearing aids being left in a drawer as the wearer can not get used to them quickly enough.

By choosing us as your independent hearing health professional, you are guaranteed a greater choice of instruments, state-of-the-art technology, shorter waiting times, and superior aftercare.

We offer many different styles of hearing aids; not to mention the multiple design and colour options that you can choose from. Each hearing instrument is selected and fitted based on each person’s individual hearing needs and lifestyle requirements.

Your hearing test will help determine which types of hearing aid are most suitable.Your hearing test will help determine which types of hearing aid are most suitable for your particular loss.

Bone conductors These can be worn on glasses, or on a band, and are an option for people with perforated ear drums, which weep. These have been superseded in most cases by bone anchored hearing aids which involve a referral for an operation.

Tinnitus Maskers Many people will experience a ringing or rushing in their head, if only momentarily. It is only when the ‘noise’ dominates a person’s life that something needs to be done. Many people suffering from tinnitus also have some degree of hearing loss.

Tinnitus maskers, or sound generators, are built into a small, simple BTE and can help to distract the brain from the ‘noise’ as well as offer the amplification needed to overcome the hearing loss.

CROS-BICROS These may be recommended where a single-sided hearing loss presents in order to provide all round hearing again. They are also now available as a wireless system.

The myriad state-of-the-art hearing instruments available all have certain characteristics in common. They are designed to selectively increase the volume of the sounds you want to hear. They can make soft sounds audible, while at the same time making loud sounds comfortable, thus providing relief in both noisy and quiet situations.

No hearing instrument can solve every hearing problem or restore normal hearing, but they are designed to provide selective amplification so that you can hear and understand better.

A microphone picks up sound and converts from an acoustic signal (one recognised by the human ear), to an electronic signal that can be recognised by the amplifier.

The digital signalling processor allows the use of special features such as sound smoothing and feedback cancellation.

The amplifier processes the electronic signals, making sounds louder. More emphasis is now being placed on what types of sounds are amplified. For example, some people are able to hear some frequencies better than others.

The receiver converts the electronic signal back into an acoustic signal that the wearer is then able to hear.

 Your hearing test will show which technology your hearing aid needs.

Hearing instrument technology has improved greatly over the years and we are now in an exciting time where digital hearing instruments are accessible to everyone. Today’s instruments offer not only superb performance, but are smaller, more efficient, and more comfortable than ever before.

The sophisticated technology of digital instruments means that they don’t just make all sounds louder. They can differentiate between sounds – separating them and presenting them in different ways. The wearer can focus on specific sounds like speech and make it easier to hear over background noise. In short, there are fewer reasons to avoid taking action!

As well as comprehensive hearing care, we are also trained to recognise the symptoms of any other conditions that may affect the ears. This diagram will show some of the complications that we are looking for during your hearing test.
Journey through the ear


Outer Ear

Be aware of any skin abnormalities and consult your GP if you notice anything unusual.

Bowl of the Ear
Mostly skin problems which become more relevant when wearing ear moulds.

Wax Glands
At the entrance to the ear canal, these are enemy number 1 for hearing aid wearers! Always try to keep your ears clean (preferably not with cotton buds).

Ear Canal
Most problems here are caused by wax or eczema which can cause infections and should be referred to a GP.

Ear Drum
These can be scarred from previous infections affecting the hearing or they could have perforations or grommets. This is a GP or hospital referral and should be mentioned at the time of consultation.


Middler Ear

Although rare in today's world because of good medication, a mastoid cavity could be part of your history and must be mentioned at the time of your hearing test.

Middle ear bones can be dislocated through a fall or a hard hit to the head which gives an apparent total deafness even though the cochlear is not affected.

The Stapes
The stapes (smallest bone in the body) can have hereditary problems, problems caused by wear and tear or problems that occur out-of-the-blue. These are for GP referral and can now be resolved with teflon replacements.


Inner Ear

Most problems here are due to the wear and tear of the little hairs which carry incoming sound to the nerves going to the brain.

Cochlea
These hairs can be damaged by sound, toxic drugs, childhood illnesses and fluid infections which can also relate to balance problems.

Auditory Nerve
Occasionally there can be damage to the auditory nerve which can be either genetic or acquired.

Many people mistakenly believe that the high street chains are the best option outside of the NHS because they have more buying power, and can, therefore, offer better value for money.

As an independent hearing practice with over 30 years’ experience, we have long-standing relationships with all of the leading manufacturers which means we can often compete on price.

Being independent also means that we also don’t have contractual ties to any particular manufacturer; so we can truly select the very best hearing instrument to suit your specific needs, rather than compromise based on what we are obliged to supply.

Another consideration may be your on-going care. High street chains can often have a high turnover of staff, meaning that you might not get to see the same person each time you visit.

Our Hearing Care Professionals have been serving the people of South London and the Home Counties through Alex Mackay Hearing for over 30 years; so you can always be sure that every appointment will be with them, and they can get to know your individual needs.

Simply give us a call and we will make all the arrangements to get it checked over and fixed or, if necessary, replaced by the manufacturer in the fastest time possible so you aren’t without your aids for long. For non-custom aid wearers, we can often supply you with a temporary replacement whilst your aids are in for repair.

Our comprehensive aftercare service is designed to help you adjust to life with hearing aids. We use the latest software to monitor the usage and see which environments and situations are causing you any issues. We can use this data to make adjustments over the course of the first few weeks.

However, if you are still simply not 100% satisfied after 30 days, you can simply return the hearing aids without charge.

All of our hearing aid products come with a comprehensive two year manufacturer’s warranty, as standard. The warranty guarantees your aids against faults, but not loss. However, we can recommend insurers that offer very reasonable policies for any loss incurred.

We stock batteries for all of the leading hearing aid types which can be purchased directly from us. Simply complete the form on the contacts page, or call us with your order.

Ask us a question

Feel free to ask any hearing related questions over the phone, or send your question via this form below. Your message will be received directly by our staff who will answer as soon as they can.