Modern treatments for people with hearing and hearing related problems only partly restore the ability to understand speech in realistic, noisy environments, and the subjective experience of devices is often poor. We require greater understanding of the underlying problems, and to address those through development of individually optimised, hearing-loss friendly solutions which maximise the possible benefits of technology. Solutions will likely involve precision engineering of wearable hearing and communication technologies, integration with mobile devices, brain-interfaces (e.g. EEG), and modelling and context-sensitive AI to remove background noise and boost attended sound, improve intelligibility and conserve power. In the longer term, the development of new pharmacological, genetic solutions and next generation implanted devices are all likely to contribute to improve hearing health.