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It’s essential that everyone who has a medical need for professional ear wax removal should be able to access an NHS service when they need it. They should also be offered clear information on how to manage excess ear wax safely at home with ear drops, when advised to.
Sadly, even though ear wax build up can cause hearing loss, tinnitus and debilitating earache, our new research report shows this isn’t the case. Help us demand change and improve access to these services by joining our ear wax removal campaign.
The problem
For many years, people could go to their GP surgery for ear wax removal – but increasingly, GP practices are no longer offering this service. Now, people must either seek private ear wax removal, costing 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.
This contradicts clear guidance from the National Institute of Health and Care Excellence (NICE) – the body that recommends which services should be available on the NHS. NICE guidelines state that GP surgeries or community clinics should offer to remove earwax, if build-up is contributing to someone’s hearing loss or causing other symptoms.
“It (hearing loss from earwax build-up) led to increased isolation, and I found I was withdrawing. It was inevitable that I had to withdraw as I felt I didn’t have a choice. My mental health is very good, but I thought to myself ‘Oh god this is really hard’, it’s not going to get any better and I saw the future as very grim, and I don’t think I’m alone in thinking that.”
Read Helen’s story about the costs of ear wax removal services.
Why is ear wax removal important?
Ear wax is a normal, oily substance that helps protect the outer ear. For most people, ear wax moves out of the ear naturally over time, however for some, such as hearing aid wearers, it builds up and requires professional removal. It is thought that around 2.3 million people require professional ear wax removal every year in the UK.
Read more about this in our report.
Ear wax build up can cause hearing loss, tinnitus, infection and earache. Hearing loss alone can cause social isolation and double the likelihood of mental health problems. Significant ear wax build up can also delay or prevent essential hearing care in audiology. Read more about the symptoms of ear wax build up.
These symptoms are usually temporary and do not continue after wax has been removed. There is no medical reason for the withdrawal of this vital service.
Service access is a postcode lottery
To get a true picture of where NHS wax removal is available in England, we submitted Freedom of Information requests to all integrated care boards (ICBs), the commissioners of most NHS services, in England. 40 out of 42 provided useful responses.
We were told that:
Less than half of ICBs are commissioning wax removal services in line with NICE guidelines.
Most ICBs commission some services but people can only access them if they live in certain parts of the ICB area. In some areas, people had to meet specific restrictive criteria, such as limiting access to the service to those 55 and over.
At least seven ICBs commission no wax removal services at all.
Read our report on ear wax removal services
What we want to change
To ensure that everybody with a clinical need for ear wax removal can access this vital service, RNID is calling for:
- Government intervention to ensure patients with a clinical need for ear wax removal have access to timely local NHS provision, regardless of where they live.
- Local NHS commissioners to investigate ways they can deliver this service in a cost-effective way.
- Commissioners to ensure their ear wax removal providers are meeting contractual obligations, and that patient-facing staff are aware of what services are available to who.
- NHS England to publish improved patient information about ear wax, so people can m
anage their ear wax safely from home. - NHS England to ensure that GP surgeries share consistent, safe and evidence-based information with their patients.
Though the majority of our report’s data is focused on England, we continue to campaign on this vital issue throughout the UK and will keep you informed of our progress across the nations.
Our previous research
We know that because people are unable to access the service on the NHS, they are attempting to manage ear wax build up themselves, sometimes on the advice of a healthcare professional, such a doctor, nurse or pharmacist.
However, recommendations around self-management don’t seem to be consistent and are not widely shared.
In the summer of 2022, we ran a survey to find out more about what advice you are getting on self-management, what action you are taking, and what has happened afterwards.
1,491 of you responded and we found that:
- 73% of respondents with ear wax build-up experienced hearing loss, and 37% experienced tinnitus. Half of respondents experienced earache or discomfort, and a quarter experienced dizziness.
- More than a quarter of survey respondents could not afford to get their ear wax removed privately, which can cost between £50-£100.This was especially problematic for hearing aid wearers, who need ear wax removed more regularly.
- Cost for private treatment and long waits for ear wax removal at hospital led many respondents to attempt to remove ear wax themselves, although two thirds did not feel confident doing this.
- Many of the methods people described to remove ear wax were dangerous, including hair clips, paper clips, toothpicks, cotton buds, and Hopi ear candles.
- After trying to remove ear wax themselves, only 20% of respondents said their problems went away, whilst 55% of people noticed no change in their condition. 1 in 10 said their symptoms got worse, or they caused themselves injury which required medical attention.
In 2021 we asked you what problems you had faced and where.
We received nearly 1,400 responses, with the majority of you telling us you were told to have your ear wax removed privately, or simply that this service was not provided on the NHS in your area. Nearly 100 people were also told to remove their ear wax themselves.
Your responses also helped us to identify where the problems were worse, and we sent Freedom of Information requests to the worst performing Clinical Commissioning Groups (CCGs – now replaced by ICBs), to find out more about their procedures on the removal of wax.
We did this to help us understand if the issue is:
- CCGs not including wax removal as a Locally Enhanced Service
- providers (such as GPs) being unaware of this
- or providers choosing not to provide the service.
Unfortunately, the responses we received didn’t give us the answers we need. Often, CCGs told us that they didn’t hold the information.
