Australians and New Zealanders with significant hearing loss are set to benefit from clearer, faster and more consistent access to cochlear implant care following the release of new clinical guidelines which remove long standing barriers to treatment.
Despite funding being widely available, only 10% of eligible adults currently receive a cochlear implant, with significant variation in access and service delivery across regions.
Peak professional bodies, including the Royal Australasian College of Surgeons (RACS) advocated for and endorses the release of new bi‑national clinical guidelines for cochlear implantation, designed to remove long‑standing barriers to access for adults across Australia and Aotearoa New Zealand. Led by the ANZ Hearing Health Collaborative, it also has the joint backing of ASOHNS, Audiology Australia, and the RACGP.
This initiative was co-chaired by Professor Payal Mukherjee, FRACS, a Cochlear Implant surgeon, Dr Jaime Leigh, Audiologist and Director, Victorian Cochlear Implant program, from the Royal Victorian Eye and Ear Hospital and Professor Bamini Gopinath, Cochlear Chair in Hearing and Health, Macquarie University.
The new binational guidelines, developed under the ANZ Hearing Health Collaborative (ANZHHC) and informed by global work from the Cochlear Implant International Community of Action (CIICA), brought together 70 stakeholders across Australia and New Zealand. Over three years, a working party of surgeons, audiologists, and consumer representatives collaborated to create these guidelines that now provide consistent standards across the entire patient journey-from referral and candidacy through to surgery and rehabilitation.
Quote attributed to Cochlear Implant Surgeon, Professor Payal Mukherjee, FRACS
These guidelines cover the entire pathway for the patient from referral to rehabilitation. It allows GPs and general audiologists understand when to identify an eligible patient and refer to a specialist. It allows Cochlear Implant specialist surgeons and audiologists to standardise their practice, so if the patient goes to two different clinics, they will get the same advice about surgery. It provides health care administrators and policy makers guidance over good governance frameworks so when they start a service, they know what is an appropriate standard of care for surgery and rehabilitation and it gives all involved a standard of measuring outcomes for patients, so we can make sure that all patients get access to the same standard of care across Australia and Aotearoa New Zealand.
Importantly, the guidelines have received patient input, including from long standing advocates and cochlear implant recipients, John Ross (CICADA) and David Brady, ensuring lived experience sits alongside clinical evidence at every stage.
Quote attributed to Cochlear Implant Recipient and lived experience input into these guidelines, John Ross
For someone who went from 16% speech recognition to 100% because of a cochlear implant, I now understand that I wasn't simply choosing a hearing device - I was choosing a better quality of life. I was choosing stronger relationships with family and friends, the ability to participate in social conversations once again, and the ability to fully function as a Husband, Father and Grandfather. These guidelines matter because they help more adults access that same opportunity.
These guidelines mean clearer pathways and more consistent access to cochlear implant care, from both a patient and clinical perspective. They address major barriers identified in research, such as mixed clinical advice, unclear referral processes, and limited confidence among regional providers to offer implant services. The guidelines also respond to the concentration of services in metropolitan centres, which leaves many rural and regional adults facing long travel times and limited specialist access. While not the complete solution to geographic inequity, the guidelines provide governance and evidence‑based pathways that support regional clinicians, including rural generalist surgeons, to deliver care locally. This guidance on candidacy, referral, rehabilitation and expected outcomes helps ensure patients outside capital cities can access timely, high‑quality cochlear implant services.
Quote attributed to Audiology Australia
Audiology Australia is proud to endorse the ANZ Adult Cochlear Implant Living Guidelines. These guidelines offer a clear, evidence based framework that supports timely, consistent, and person centred care for adults who may benefit from cochlear implantation. By standardising referral pathways, candidacy criteria, rehabilitation, and outcome evaluation, they help ensure equitable access and high quality care nationally. The guidelines strongly align with Audiology Australia's commitment to providing clinical guidance that supports evidence based best practice and improved hearing health outcomes. We are pleased to have contributed to the ANZ Hearing Health Collaborative and wholeheartedly support the national implementation of these guidelines.
This collaborative effort is a strong example of clinical leadership and advocacy in action. By bringing together surgeons, audiologists, and lived experience voices, the sector has created a practical, evidence‑based framework that will make the cochlear implant journey clearer, more consistent, and easier to navigate for patients and families into the future.
