A hearing loss charity has called for ear wax removal to be reinstated as a nurse-led NHS service, following a report which revealed the difficulties people are facing when trying to get their ear wax professionally removed.
The report from the Royal National Institute for Deaf People (RNID) explained that redcued targeted funding and staffing pressures have led to a decrease in ear wax removal services in the NHS.
The charity surveyed 1,491 adults and over half said they had sought advice on ear wax removal since the first coronavirus lockdown in March 2020.
Of those who had sought advice, 66% reported that they had tried to get their ear wax removed on the NHS but were told that the service was no longer available.
“Getting ear wax removed in primary or community care settings is better for the patient, and cheaper for the NHS”
The report described how previously patients could access ear wax removal services on the NHS, often through a practice nurse, but now they were being told to pay for private services or remove the wax themselves.
The charity warned that people were using dangerous methods to remove ear wax, such as hair clips, paper clips, toothpicks, cotton buds and ear candles.
After trying to remove the wax themselves, only 20% of respondents said their problems went away, while 55% noticed no change in their condition.
Of the people who used home methods to remove wax, one in 10 said their symptoms got worse, or they caused themselves injury which required medical attention.
Crystal Rolfe, associate director for health at RNID, told Nursing Times that guidance from the National Institute for Health and Care Excellence states that ear wax removal “should be offered where there is clinical need”.
She also warned that if ear wax was left, it could cause temporary hearing loss, tinnitus, earache and risked other infections.
Ms Rolfe said: “We know that not everyone can afford private removal, and as a result many people are putting their hearing at risk by trying to remove ear wax themselves.”
For those in the report who could get an appointment, many said that they had to go to hospital instead of their general practice.
The report noted that ear wax removal services in hospitals were generally run by ear, nose and throat departments, making an appointment in this setting “more expensive than primary or community care”.
Ms Rolfe said: “Getting ear wax removed in primary or community care settings is better for the patient, and cheaper for the NHS.”
She added: “We are pleased to see that some areas have received funding to deliver wax removal as part of a locally enhanced service (LES), and that some pharmacies are piloting the service.
“However, we know that many people across the UK are still not able to access NHS ear wax removal.”
Ms Rolfe called on health bodies to “explore new models for delivering ear wax removal services” to enable people who need professional ear wax removal to access timely and appropriate treatment.
Also concerned about the RNID report findings was ear, nose and throat clinical nurse specialist Hilary Harkin.
Ms Harkin told Nursing Times that she thought irrigation services (removing with water) should return to general practices, and that ear wax microsuction services should also take place in the community on behalf of the NHS.
“Usually the want for greater pay and less patient numbers will prove too tempting and they leave us”
The RNID report explained that this large-scale withdrawal of service provision was because of factors including “lack of targeted funding and ongoing pressures within the NHS from the coronavirus pandemic”.
Ms Harkin said she too had noticed “many changes in the provision of ear care” in recent years, as a result of nursing staff shortages.
She said many nurses she had trained to perform microsuction had moved to work for private companies due to the offer of better pay.
She said: “I encourage our microsuction nurses to work in both the NHS hospital environment combined with private services, but usually the want for greater pay and less patient numbers will prove too tempting and they leave us.”
Meanwhile, Ms Harkin said that due to a recent change in hospital site, her microsuction clinic team of four nurses was reduced to just one ear care nurse, leading to the service being overrun and “unable to cope”.
As a result, the clinic was suspended and patients have since been advised to attend their general practice for a referral to Specsavers.
However, Ms Harkin warned that some private microsuction providers lacked the same training as nurses, which could lead to the ear wax issues being “not fully resolved”.
“I will often find patients have been treated by non-NHS providers but they leave wax near the ear drum as they are unable to remove it for fear of damaging the ear drum,” she said.
Ms Harkin also called for nurse-led services in primary care to be invested in, to help target the backlogs in ear, nose and throat clinics.