Hearing Loss (audiology)


Sudden loss or sudden deterioration of hearing (sudden = within 72 hours) (British Academy of Audiology, 2016)

Useful Management Information
  • Refer to ENT CPC, Health pathways or local guidelines
  • In cases of sudden deterioration of hearing, do otoscopy to check for ear infections and use tuning fork tests (if available) to try to differentiate sensorineural (urgent) from conductive (non-urgent) hearing loss. See links to tuning fork tests (Weber & Rinne) below.
  • In cases of sudden sensorineural hearing loss, accessing treatment (e.g. Prednisone and/or hyperbaric oxygen) ASAP is essential to help optimise hearing outcomes.
  • For hearing aid wearers, refer to their local hearing aid provider to ensure optimal hearing aid fitting
  • High incidence in refugee community and patients with poor access to primary health care
  • Over half the population aged between 60 and 70 has a hearing loss
  • People who have difficulty hearing and who want to use hearing aids are most likely to gain benefit from their use
  • Give the person and, if they wish, their family or carers, information about:
    – the causes of hearing loss, how hearing loss affects the ability to communicate and hear, and how it can be managed
    – organisations and support groups for people with hearing loss

Inform the patient

  • Ensure they are aware of the request and the reason for being assessed.
  • Instruct them to take all relevant radiology films and reports (including the imaging report) to appointments.
  • To advise of any change in circumstance (e.g., getting worse or becoming pregnant) as this may affect the request for assessment.

Clinical resources

  • Weber & Rinne tuning fork tests: https://www.youtube.com/watch?v=RVH4K4EcsiA
  • Recommended Procedure Tuning Forks
  • If eligible for Office of Hearing Services Hearing Program e.g. pensioners, Veterans etc. and likely to require hearing aids refer directly to OHS
  • NICE Guidelines: Hearing loss in adults: assessment and management
  • NICE Guidelines: Hearing loss pathway

Patient resources

  • Refer pensioners, Veterans etc. to OHS if eligible
  • Australian hearing
  • Refer to Australian Hearing if:
    – younger than 26 years or
    – an Aboriginal and Torres Strait Islander who is over 50 years (also see other ATSI eligibility at OHS website).
  • NDIS Hearing loss criteria
Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)
  • Sudden (≤ 1 week) onset off loss of hearing, unilateral or bilateral and not associated with outer or middle ear disease
  • Sudden onset deterioration
  • Post head trauma - hearing loss
  • Fluctuating hearing loss other than associated with colds
Category 2 (appointment within 90 calendar days)
  • Hearing loss associated with ear disease e.g. perforation, discharging ear
  • Syndrome or disorders associated with hearing loss (i.e Paget’s disease, neurodegenerative disease, osteosclerosis)
  • Chronic hearing loss - change in symptoms or clinical findings
  • Adults with hearing loss which is affecting communication and treatable conditions have been excluded
  • Failed screen
  • Family history of hearing loss
Category 3 (appointment within 365 calendar days)
  • Gradual onset of hearing difficulties, e.g. presbyacusis
NB Hearing Aid dispensing (Hearing service program)


Standard Referral Information

Patient's Demographic Details

  • Full name (including aliases)
  • Date and country of birth
  • Residential and postal address including whether patient resides at an aged care facility
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Name of delegate and contact details (Department of Corrective Services)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Relevant clinical information about the condition

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • All conservative options that have been pursued unsuccessfully prior to referral
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
  • Any special care requirements where relevant (e.g. tracheostomy in place, oxygen required)
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

Reason for request

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

Clinical modifiers

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living functioning – low/medium/high
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

Other relevant information

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc

Essential referral information

Without this information the referral will be returned

  • History including relevant symptoms, comorbidities, cognitive ability, physical mobility and dexterity (NICE Guidelines, 2018)
  • Description of:
    – hearing loss i.e. one or both sides
    – change in hearing loss (sudden, rapid or gradual)
    – failed screening results
    – describe symptoms that are persistent and/or troublesome to patient or family
Additional Referral Information
  • Family history of hearing loss
  • Any previous surgery or treatment
  • Information regarding any hearing aids or hearing devices and communication mode utilised by the patient e.g. Auslan
  • Speech discrimination testing
  • Any previous audiology assessment results
  • The person's hearing and communication needs at home, at work or in education, and in social situations
  • Psychosocial difficulties related to hearing

Out of catchment

West Moreton Health is responsible for providing a public health service to people who reside within its catchment area. To appropriately manage demand for service we do not accept referrals from outside this catchment area. If your patient does live outside the West Moreton Health area and it is deemed socially or clinically necessary for their care to be received in the West Moreton Health Service, inclusion of information regarding their particular medical and/or social factors will assist with the triaging of your referral.


To provide feedback about contents on this website or general referral questions please email WM-CPC@health.qld.gov.au or phone 3413 7402.