Objectives: To report the clinical results of a bone-anchored hearing aid (BAHA) programme in a district general hospital, compared with those in an established, large, university teaching hospital centre.

Design: A retrospective postal questionnaire sent to BAHA patients, with two month waiting time and one reminder, combined with case note analysis. Results compared by appropriate statistical tests with published outcomes data from the largest UK series.

Setting: Public sector (National Health Service) district general hospital, England. Catchment population: 300 000 (mixed rural and small towns).

Participants: Case note analysis of sixty-three patients implanted between 1994 and 2003 (age range, six to 88 years). The commonest indication was chronic otitis media, with inability to wear a conventional hearing aid. Otitis externa, otosclerosis and sensorineural hearing loss were other indications. The questionnaire was sent to 59 patients who had worn their aid for at least six months; it was returned by 41 (69 per cent).

Main outcome measures: Glasgow benefit inventory (GBI, change in health status following otolaryngological intervention); incidence of complications.

Results: Bone-anchored hearing aid implantation significantly improved quality of life as measured by the GBI (p < 0.001). The degree of improvement was similar to that achieved in Birmingham by Proops et al. (p > 0.05, chi-squared test). Minor temporary skin infection was common (33 per cent). Thickening of the skin around the implant occurred in 17 per cent. One implant (2 per cent) failed. There were no serious complications.

Conclusion: The BAHA is a safe, reliable and effective treatment for selected patients. A successful BAHA programme can be run in a district general hospital.