Targeted adult hearing loss screening in the UK: policy options for equitable implementation through health-service pathways.

Adult hearing loss is common, disabling, and frequently under-detected, with help-seeking often delayed and unmet need unevenly distributed across populations. In the UK, adult hearing-loss screening is not currently recommended, and detection largely depends on self-recognition, primary-care presentation, and referral. This Policy Brief examines three policy options: maintaining the status quo, introducing age-based screening at 60, 65 and 70 years, and implementing targeted risk-based screening through existing health-service pathways for adults at elevated risk of cognitive decline. Appraisal against public health impact, feasibility, equity, and economic considerations suggests that targeted risk-based screening is the most immediately viable option. A phased pilot embedded in dementia, mild cognitive impairment, NHS Health Check, and audiology pathways could generate implementation evidence while improving equitable access to hearing care.