The British Academy of Audiology calls for return of NHS GP ear wax removal services for all

The British Academy of Audiology (BAA) supports the findings of the recent RNID report, which highlights the lack of access to essential ear wax removal services for millions of people across England. The BAA echoes the RNID’s call for urgent action to ensure that everyone who needs ear wax removal has access to this vital service through the NHS.

Currently, 8.1 million people in England cannot access NHS ear wax removal services. As a result, many are turning to risky DIY methods or paying for private treatments that are often unaffordable. These practices can sometimes lead to preventable hearing loss and other serious health complications.

Claire Benton, President of the British Academy of Audiology, commented: “Access to safe, professional ear wax removal is crucial to prevent avoidable hearing loss and related health issues. The ongoing postcode lottery of NHS services is causing unnecessary suffering, with individuals left to resort to dangerous self-management or private services they cannot afford. We call on all GPs to return to providing NHS wax removal services, ensuring everyone has access to safe and affordable care in line with NICE guidelines.”

GPs are not incentivised to offer these services through their contracts, and Integrated Care Boards (ICBs) are not routinely providing funding for the service to be delivered in other settings across the NHS. The BAA fully supports RNID’s Stop the Block campaign and urges the Government to work with GPs and ICBs to ensure equitable access to ear wax removal services for all patients.

The BAA are a founding member of the National Aural Care Strategy Group which has been formed to address some of the significant concerns that have been raised about patient safety and aural care. Read more about the group and its aims here: National Aural Care Strategy Group

Access the RNID report here: www.rnid.org.uk/stoptheblock

The RNID press release states:

Millions left with zero access to NHS ear wax services leading to risky DIY removal methods and preventable hearing loss

• 8.1 million people in England have zero support available from the NHS if they need their ear wax removing.
• Postcode lottery of wax removal forcing many people to self-manage ear wax at home or go private, which more than a third say they cannot afford.
• Widespread use of dangerous DIY ear wax removal methods, with 1 in 20 being driven to use items such as tweezers or hairpins which can cause permanent damage.
• Painful and distressing symptoms experienced by people who need professional ear wax removal: Almost half (45%) experienced hearing loss, a third earache, a quarter tinnitus. 1 in 5 experienced poor mental health and isolation and more than 1 in 10 people admitted having to take time off work.
• RNID’s Stop the Block campaign is calling on the Government to urgently step in to ensure everyone who needs wax removal can access it on the NHS.

A new report has exposed a serious lack of progress on the availability of ear wax services in England, leaving 8.1 million with zero support and at risk of preventable hearing loss.

Research from RNID, the charity supporting people who are deaf, have hearing loss or tinnitus, has revealed a postcode lottery across England, as almost half (45%) of Integrated Care Boards (ICBs) – the commissioners of most NHS services – are still not providing wax removal services in line with public health guidelines.

An estimated 2.3 million people in the UK require professional ear wax removal every year. Older people, hearing aid users and people with learning disabilities are more likely to be at risk.

According to the report, in areas with zero service, people with ear wax build-up have no choice but to pay for private removal, which can cost up to £100 per session. With 1 in 10 people requiring ear wax removal three or more times per year, this can become prohibitively expensive and more than a third surveyed by the charity say this is unaffordable.

Without access to ear wax services, many people are also left to attempt ear wax removal at home. A survey conducted by RNID has revealed the extent to which dangerous DIY self-management methods are used, despite the fact these methods are known to cause infection, ear canal or ear drum damage and permanent hearing loss.

When a nationally representative sample of people in the UK were asked the question: “what have you used to remove or treat ear wax at home?” 1 in 3 (33%) surveyed said cotton buds, making it the most common risky DIY method. 1 in 20 people admitted using tweezers or hairpins.

1. Cotton buds – 1 in 3 (33%)
2. Finger or fingernail – almost 3 in 20 (14%)
3. Earwax scoop removal tool – over 1 in 20 (6%)
4. Ear candles – 1 in 20 (5%)
5. Tweezers – 1 in 20 (5%)
6. Hairpins or bobby pins – 1 in 20 (5%)

Further polling from RNID has revealed the painful and distressing symptoms faced by people unable to access the necessary wax removal services. Nearly half (45%) experienced hearing loss, a third experienced earache, and a quarter developed tinnitus. Additionally, one in five reported poor mental health and feelings of isolation, whilst 1 in 10 had to take time off work as a result.

For many years, wax removal was available at GP surgeries, but the latest research from the charity shows that half of people with ear wax build-up have been forced to pay for ear wax removal services, with the majority doing so because of a lack of NHS services locally.

To address the ongoing crisis, RNID has launched the Stop the Block campaign and is urging the Government to step in to ensure everyone who needs wax removal can access it on the NHS. The charity is calling on the Department of Health and Social care to:

• Work with ICBs and ensure that everyone with a medical need for wax removal has free access to it, in line with NICE (National Institute of Clinical Excellence) guidance.
• Publish improved patient information on the self-management of ear wax, so people can manage their wax safely from home, and ensure that GP surgeries share consistent, safe and evidence-based information with their patients.

Audrey Houghton, 70, from Biggleswade has recurring ear wax build-up which affects her hearing. It’s an issue she has had since she started using hearing aids around 20 years ago. Regular treatment at her local GP surgery helped manage the problem, but three years ago she was told the service was no longer available and was advised to go privately. However, a bad experience with a private ear wax removal service made Audrey reluctant to go back for more treatment. The impact on her life was significant.

“I loved going out and talking to people. I used to go to church meetings, but I stopped going. I couldn’t hear what they were saying unless my daughter was with me explaining what they said, or it was just hopeless.

“I was isolated. I just felt like giving up. I couldn’t go out. I thought I’d have to stay at home indefinitely. I used to go to keep fit class, which I stopped going to. I stopped shopping as I couldn’t really understand what the cashier was saying. I was relying on my daughter to do things for me it was quite depressing and draining for me. I was exhausted and became frustrated with myself.”

In November last year the situation had become so serious, that Audrey’s daughter urged her to go back to her doctor. She was referred to her local hospital for microsuction treatment which cleared the ear wax.

“If it wasn’t for my daughter, I would’ve thought well this is it. I like going out, I like people, I like doing things. Now I’m going to go to my keep fit class, I’m going to go dancing, I’m getting my life back.”

“I didn’t realise that it’s a postcode lottery getting ear wax removal and that in some places you can still get the service for free. It’s not fair to do that. For deaf people and hard of hearing people daily life is difficult enough as it is.

“We don’t want to stop doing things and it is a lot of money really to pay privately; not everybody has the money. But as you get older, you are going to get these things happening to you like hearing loss and we should have access to what we need.”

Crystal Rolfe, Audiologist and RNID Director of Strategy, said:

“It is unacceptable that millions of people across England are still unable to access vital ear wax removal services from the NHS in their local area. Thousands are being forced endure painful and debilitating symptoms, or resorting to costly private treatment – options that many simply cannot afford.

“Whilst some improvements have been made over the past year, they fall well short of what is needed. The pace of progress remains too slow and without clear national leadership, health inequalities will persist, leaving countless people without the care they require.

“We urge the Department of Health and Social Care to commission an urgent review to ensure that everyone who needs ear wax removal has access to local NHS services when they need them.”

Freedom of Information (FOI) requests submitted by RNID to all 42 ICBs in England show that 23 now offer a full-service provision in line with guidelines from the National Institute of Health and Care Excellence (NICE) an increase in five from the previous year. However, 19 ICBs are still only providing a partial service.

In its latest report, RNID found that there are 6 ICBs that still don’t commission ear wax removal services at all. These are: Birmingham and Solihull, Cornwall and Isles of Scilly, Dorset, Mid and South Essex, North West London and Suffolk and North East Essex.

The report also shows that there are 13 ICBs in England partially commissioning services, with the majority providing ear wax removal only within limited areas inside their geographical footprint. In some places where the service is commissioned, not all GP practices choose to deliver it. Some ICBs also have restrictive criteria such as only offering the service to people over 55, which goes against NICE guidelines.

For more information and to support RNID’s Stop the Block campaign, visit www.rnid.org.uk/stoptheblock