Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if she will require NHS England to publish commissioning guidance to integrated care boards on universal provision of ear wax removal services.

In June 2018, there was an update to the National Institute for Health and Care Excellence’s (NICE) guidance, which states that ear wax syringing is no longer recommended due to safety concerns. Instead, self-care methods including olive-oil drops and, if required, ear irrigation or micro-suctioning, are recommended.

The Government has no plans to include ear wax removal services in the national Standard General Medical Services Contract. Irrigation and micro-suctioning require a higher level of expertise and specialist equipment than syringing, which most general practices (GPs) do not have. This means that patients who were previously treated with syringing by their GPs may now require a referral to other National Health Service providers, to access irrigation or micro-suctioning services.

Local commissioners, including integrated care boards, are responsible for arranging services which will meet the recommendations on ear wax removal, as set out in the NICE guidance. This may involve commissioning GPs who agree to develop the required expertise to deliver these treatments or other providers, to whom GPs may refer patients, to provide ear wax removal services.

NHS England issued a communication to all commissioners in June 2022 which asked them to ensure that GPs, with whom they have agreed will not deliver ear irrigation or have not been commissioned to provide micro-suction services, are able to refer patients to appropriate local NHS services for ear wax removal, where symptoms persist following self-care methods. This includes arranging services in line with guidance on ear wax removal services, published by NICE. This guidance is available at the following link:

https://www.nice.org.uk/guidance/ng98/chapter/Recommendations#removing-earwax

The Department is not aware of any plans by NHS England to appoint a national clinical director or speciality advisor for ear wax removal services. Finally, the Department has noted the publication of the Royal National Institute for Deaf People’s (RNID) report Blocked Ears, Blocked Access with interest, and will meet with members of the RNID to discuss this report in due course.