Ear Wax

Ear Wax/Syringing

As of Monday 16th September 2019, we no longer provide ear syringing at the surgery.

This has not been an easy decision for the practice to make, however it has been taken with patient safety in mind and in line with NHS advice. Recently, there has been an increase in the number of adverse effects being reported nationwide following ear irrigation. These include: perforation of eardrum, pain/discomfort or bleeding during procedure, risk of infection and increase in production of wax.

Wiltshire Clinical Commissioning Group, who commission primary and secondary care services locally have also released a statement to practices confirming that “Ear Syringing in Primary Care is not a commissioned service”, that is “ear syringing has never been funded by the CCG”. Previously some practices have chosen to provide this service, unfunded, to their patients. However, in the time of increasing demand as well as growing evidence of the possible risks, we are not able to continue to offer this service.

As a result, patients are being encouraged to take some measures to limit the build-up of wax. Advice is available via the Blocked ears wax self guidelines for patients document, and the LMC ear wax guide.

If further intervention is required then patients may need to have a procedure called “micro-suctioning”. This is available on the NHS, and the CCG have shared the following with all local practices:

The CCG also recognises that patients suffering from significant symptoms due to ear wax build up (including hearing loss or pain) and affecting a patient’s condition may warrant micro-suction, where one or more of the following has occurred:

• Previously undergone ear surgery (other than grommets insertion that have been extruded for at least 18 months)
• A recent history of Otalgia and /or middle ear infection (in past 6 weeks)
• A retraction pocket or a cholesteatoma
• Has a current perforation or history of ear discharge in the past 12 months
• Previous complications following ear irrigation including perforation of the ear drum, severe pain, deafness, or vertigo
• Ear drops have been unsuccessful and irrigation has been unsuccessful or is unavailable

If all of the above criteria are met, a prior approval application may be made from your GP and will be granted for on-going treatment (to a maximum limit).

Further details are available on the ear wax removal (adults only) information document.

A referral from your GP to a hospital for ear wax removal is only commissioned for patients meeting certain criteria, including;

• Patients with acute otitis externa up to a maximum of three appointments per year (To be monitored via the audit process)
• Patients who require Micro-suction prior to the assessment, fitting or review of a hearing aid
• The tympanic membrane is obscured by wax but needs to be viewed to establish a diagnosis
• There is a foreign body, including vegetable matter, in the ear canal that could swell during irrigation

If patients do not meet the criteria set out by the CCG, then they may still access micro-suction services through private providers. This service is offered by most large high street Hearing Centres or private clinics for a fee.