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A new report from RNID has exposed the postcode lottery of NHS ear wax removal services in England.
Our new research revealed that less than half of Integrated Care Boards (ICB), the commissioners of most NHS services, are providing wax removal services in line with public health guidelines. Some parts of England don’t commission the service at all, leaving 9.8 million people totally without access on the NHS if they need it.
We’re demanding for change in our ear wax removal campaign.
Distressing symptoms
Ear wax build up can cause painful and distressing symptoms – such as hearing loss, tinnitus and debilitating earache. Hearing loss alone can lead to social isolation and double the likelihood of mental health problems, and too much ear wax can delay or prevent essential hearing care, such as getting a hearing test or being fitted for a new hearing aid.
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, and many people need professional removal multiple times a year – which if forced to go privately, can become very expensive.
For many years, people could get wax removal at their GP surgery, but increasingly this service is no longer offered. Our 2022 report found that two thirds (66%) of people with ear wax build-up were told the service was no longer available on the NHS, leaving them to suffer in silence or fork out for private removal services, which 26% said they couldn’t afford. Now, new research has revealed the extent of the postcode lottery.
Access blocked
We submitted Freedom of Information requests to all 42 ICBs in England, of which only 18 said they fully commission ear wax removal services in line with guidelines from the National Institute of Health and Care Excellence (NICE).
15 ICBs partially commission 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 which goes against NICE guidelines, such as only offering the service to people over 55.
We found that 7 ICBs don’t commission ear wax removal services at all, leaving approximately 9.8 million people totally without access on the NHS. These areas are Birmingham and Solihull, Dorset, North West London, South West London, Suffolk and North East Essex, Mid and South Essex, Cornwall and The Isles of Scilly.
In these places, people with ear wax build up have no choice but to pay for private removal, which can cost up to £100, or attempt to manage their ear wax themselves. If done incorrectly, this can lead to infection, permanent hearing loss, ear canal or ear drum damage.
To address this national crisis, we are calling for the Department of Health and Social Care to commission an urgent review of NHS provision. Our call is backed by the UK’s leading audiology professional bodies, including the British Academy of Audiology and the British Society of Audiology.
We are calling for:
- Urgent government intervention to ensure that patients with a medical need for ear wax removal have access to the service on the NHS, regardless of where they live.
- Health commissioners to examine different ways of delivering the service through primary and community care, and ensure that where the service is commissioned, ear wax removal providers are delivering the service as contracted.
- NHS England to improve its information about how patients can manage ear wax build-up, and ensure that GP surgeries share consistent, safe and evidence-based information with their patients.
Demand change
Helen Kendall, 76, from Bath, pays £240 a year to get her ear wax removed privately as there is no NHS service in her area. A retired university counsellor and keen singer in her community choir, Helen says the service is essential for her wellbeing. She said:
“I was so desperate that I paid £80 to have my ear wax removed privately. It made a huge difference to my hearing and quality of life. I’m a sociable person, I volunteer at a food bank, I’m part of an art group and cook for a lunch club and I love the cinema; all these rely on me being able to hear properly.”
Read the rest of Helen’s story about access to ear wax removal services.
Victoria Boelman, Director of Insight and Policy at RNID, said:
“It’s absolutely wrong that people in England who need ear wax removal to be able to hear and take part in everyday life are being left to face painful and debilitating symptoms, forced to fork out for private treatment, or risk dangerous self-removal methods.
“There is no medical reason for the withdrawal of this vital service, which is essential for 2.3 million people in the UK. This report exposes a horrifying reality for thousands of people being let down by commissioners who are neglecting public health guidelines. We’re calling for the Department of Health and Social Care to commission an urgent review to ensure that everyone who needs ear wax removal can access local NHS provision, whenever they need it.”
RNID’s campaign is supported by professionals in the audiology industry, including Professor Kevin Munro, Professor of Audiology at Manchester Centre for Audiology and Deafness. He said:
“RNID’s new report is a wakeup call. Remove the postcode lottery, follow NICE guidance, and improve the quality of life for over two million people who need ear wax removed each and every year, often on multiple occasions.”
Demand change
What about the rest of the UK?
Welsh and Scottish governments are both committed to ensuring the availability of NHS wax removal services in line with NICE guidance. RNID will continue to work collaboratively with both to ensure their goals are met. We will lobby for the same commitment in Northern Ireland once devolved government is restored.