Much as I hate it, I have to do plenty of hedgetrimming to make ends meet. A lot of tree companies here do the same. There's an awful lot of hedges over here, and it all amounts to easy repeat business if you do a good job. I have petrol Stihl hedgetrimmers, which are a bit awkward. Handles are a bit like a chainsaw. The newer design of handles are a lot better. I've got a step ladder/extension ladder for balancing on to get higher than 7' or so. I don't like ladders, and most gardens in England are so full of crap, like rockeries, gnomes and god knows what else, that setting up and moving the ladders around and getting them stable enough to work on takes forever, and involves planks, wedges, piles of bricks, etc. If the hedge is too big for the stepladder, I convert it to a normal extension ladder and lean the ladder against the hedge. I don't like doing this, because the ladder sometimes twists, or even slips at the bottom, as you get near to the top. I usually tie the bottom to a trunk to make sure it doesn't slip completely. For the tops, and for bits where it's difficult or strenuous, say at the extremes of the ladder, i'll use hand shears. For some hedges/clients, I'll do it all with hand shears; many older clients think you get a better finish with hand shears, and they're probably right. If the time saving justifies it, and if I can get it in, I'll hire a self propelled work platform rather than use the ladder, to save all that messing about.
One neat trick a friend uses on a regular leylandii job: this hedge was topped a while ago, and regrew around 4' above the topping points, so he's nailed planks along the top to form a walkway.