Wax removal services

Members may be aware of some discourse on social media around wax removal services. To clarify some of the less helpful discussion, BAA released a joint statement with BSA to clarify our position (read the statement here).

Both organisations firmly believe that all patients who need wax removal should be able to access safe and effective services delivered by trained and competent professionals, and that these services should be available free at the point of delivery through NHS pathways. However, this does not mean that these services must be delivered by NHS Audiology or ENT services. With increased demand, ongoing workforce shortages, and waiting list challenges within the NHS, it will be appropriate for some of the 42 English ICB’s to commission other providers to provide wax removal, with different models of service provision to meet the needs of the local population. And of course, there is clearly a need for safe and competent private providers for service users who may prefer to access paid-for wax removal services.

Currently, we know that many audiologists, Hearing Aid Dispensers, and some nurses have the training and experience to extend their scope of practice to include wax removal. But there may be other professional groups who will also have the appropriate knowledge and professional lines of accountability to provide the service safely with the appropriate training. However, there is increasing concern about the growth in wax removal performed by people outside the appropriate clinical professions, without adequate training, supervision, or accountability of a registered profession.

Thus, the group of stakeholders considering best practice for wax removal have reconfigured – with their chief focus now being to produce recommendations on minimum training and competency standards, and to explore regulation/registration options. There is a high level of subject matter expertise within this group – with ENT doctors, NHS and private sector audiologists – and representation from education and the National School, and from RNID, who have been instrumental in raising awareness of the problems many people face accessing ear wax removal services. The professional bodies BAA, BSA, BSHAA and AIHHP have identified shared concerns and are all keen to work collaboratively within this group.

There is no quick fix to the lack of regulation of wax removal providers, and it certainly isn’t possible to set up a mandatory register in the short term. But the way forward is to agree “what safe looks like” and then work collaboratively with others to ensure that this is embedding into commissioning, and into the public’s expectations of providers.