OBJECTIVE The main objective of this national survey was to check the findings of an earlier pilot survey. This had found that patients who had a hearing-impairment and were in hospital were often seriously disadvantaged by their disability. METHODS The survey was conducted by questionnaire and the sampling frame confined to hearing-impaired patients who had been in hospital during the previous three years. A total of 359 completed and valid questionnaires were returned. RESULTS The responses confirmed the finding of the pilot survey. They indicated that there were serious shortcomings in the ability of many hospital staff to cope with the problems of hearing-impaired patients. CONCLUSIONS Common causes of the problems were identified. The major factor was inadequate training of both nurses and doctors in deaf awareness and the associated communication skills. Other significant factors included patients concealing their disability, pressure of work and poor communication between staff. Appropriate training at all staff levels should eliminate a high proportion of these problems.