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    Critical assessment of evidence to help you make decisions. Advice, rather than formal NICE guidance. Published advice on this topic 1.

    Published quality standards on this topic 2. Interactive topic-based flowcharts that allow you to navigate our recommendations on any subject.

    Stakeholders can comment on draft guidance and participate in workshops and events. NICE says people growing older with learning disabilities need to have annual health checks to help them manage conditions that can quickly affect them as they grow older.

    Examples of how our guidance and standards have been put into practice in the NHS, local authorities, voluntary sector and a range of other organisations.

    Guidance We use the best available evidence to develop recommendations that guide decisions in health, public health and social care.

    Published guidance on this topic 4 New guidance in the last 6 months 2 Updated guidance in the last 6 months 0 In development guidance 2 NICE advice Critical assessment of evidence to help you make decisions.

    Early and appropriate management of hearing difficulties is also important. Particular reference is made to those with learning or cognitive difficulties such as dementia who may not be aware of their hearing problems.

    For someone with sudden hearing loss where the cause is not obvious, they should be referred immediately to a specialist service or to an emergency department, if appropriate, the draft guidance says.

    Other recommendations focus on audiological care including assessment, when to provide hearing aids, review and aftercare.

    Advice and support for individuals and their families is also recommended. We encourage those working in primary and specialist services, patients and stakeholders to comment on the proposed advice.

    The final guideline can be found here. Earwax build-up which is causing hearing problems should be managed in primary or community care. Our draft recommendations can help improve care for people with hearing loss through better management of earwax and referring people with symptoms to the right service at the right time.

    Patients should be given ear drops to soften the wax before irrigation, the draft guidance says.

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    Published quality standards on this topic 2. Interactive topic-based flowcharts that allow you to navigate our recommendations on any subject.

    Stakeholders can comment on draft guidance and participate in workshops and events. NICE says people growing older with learning disabilities need to have annual health checks to help them manage conditions that can quickly affect them as they grow older.

    Examples of how our guidance and standards have been put into practice in the NHS, local authorities, voluntary sector and a range of other organisations.

    Guidance We use the best available evidence to develop recommendations that guide decisions in health, public health and social care.

    Published guidance on this topic 4 New guidance in the last 6 months 2 Updated guidance in the last 6 months 0 In development guidance 2 NICE advice Critical assessment of evidence to help you make decisions.

    Published advice on this topic 1 New advice in the last 6 months 0 Updated advice in the last 6 months 0 In development advice 0 Quality standards Set out priority areas for quality improvement in health and social care.

    Published quality standards on this topic 2 New quality standards in the last 6 months 2 Updated quality standards in the last 6 months 0 In development quality standards 2.

    NICE Pathways Interactive topic-based flowcharts that allow you to navigate our recommendations on any subject. Other methods of removing earwax include microsuction and manual removal.

    Microsuction can only be used if the correct training and equipment is in place, NICE says. Ear syringing, where a manual syringe pumps water into the ear, is potentially harmful and should not be used.

    Katherine Harrop-Griffiths, consultant in audiovestibular medicine and chair of the guideline committee, said: Ear drops should be used to soften the wax before irrigation, either immediately before or for up to five days before the procedure.

    Early and appropriate management of hearing difficulties is also important. Particular reference is made to those with learning or cognitive difficulties such as dementia who may not be aware of their hearing problems.

    For someone with sudden hearing loss where the cause is not obvious, they should be referred immediately to a specialist service or to an emergency department, if appropriate, the draft guidance says.

    Other recommendations focus on audiological care including assessment, when to provide hearing aids, review and aftercare.

    Advice and support for individuals and their families is also recommended.

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