Almost 10 million people in England are facing a significant healthcare challenge as they can no longer access free NHS earwax removal services, warns the Royal National Institute for Deaf People (RNID). The hearing loss charity emphasises that there is "no medical reason" for the withdrawal of these vital services across parts of England since 2019. This troubling situation has led some individuals who cannot afford private treatment to resort to "dangerous self-removal methods."
Earwax buildup in the ear canal can cause various distressing symptoms, including tinnitus, earache, and hearing loss. It is a common issue, particularly among older individuals, hearing-aid users, and those with learning disabilities. The obstruction of the ear canal often necessitates earwax removal before a hearing test and can interfere with hearing aids, producing an annoying whistling sound.
Signs of Earwax Accumulation
- Hearing impairment
- Ear discomfort or a sensation of blocked ears
- Ringing or buzzing in the ears (known as tinnitus)
- Vertigo, characterised by dizziness and nausea.
The National Institute of Health and Care Excellence (NICE) guidelines specify that earwax removal services should be accessible in the community, but many GP Surgeries are no longer funded to provide this service. The two primary methods for removing earwax are microsuction, which employs a small vacuum to extract the wax, and electronic irrigation, where a machine gently pumps pressurised water into the ear.
The RNID conducted Freedom of Information requests to all 42 integrated health boards across England. Of the 40 that responded:
- 18 funded a full service.
- 15 restricted eligibility or did not offer the service across all their GP surgeries.
- Seven commissioned no treatment at all.
Crystal Rolfe, the director of health at the RNID, expressed concern, stating, "For the 10 million people who live in areas where there is no provision, the only option is to pay for it, which we know can cost up to £100 for just one procedure." She cited research indicating that 26% of people cannot afford these costs, particularly when they require multiple ear wax removals annually.
The RNID acknowledges that NHS boards are working under financial constraints, but they assert that this should not justify reducing the provision of essential earwax removal services. In some areas, patients are being informed that the service no longer exists despite GPs still being contracted to provide it. The charity fears that more people may resort to unsafe self-removal methods, advising individuals to "never put anything in your ear smaller than your elbow."
Objects like cotton buds, paper clips, hairpins, and even fingers should never be used in the ear canal itself. The RNID suggests that if earwax becomes lodged in your ear, it is advisable to consult a GP, who may recommend using olive oil drops initially.
While over-the-counter commercial drops are available, there is "little evidence" that they can resolve the issue in more than one out of every five people, according to the RNID. Such drops are not recommended for those who have recently had an ear infection or surgery, and patients are encouraged to seek advice from a pharmacist.
The government emphasises that local health boards are responsible for commissioning services based on the needs of their populations. GPs still have the option to refer patients to a specialist audiology service if earwax-related symptoms are linked to hearing loss.
If you are registered with our NHS practice, GP at Hand, and worried about your ear health, you can speak with one of our Clinicians for more advice, , including at weekends. Message our Support Team for more information.