Patients go private over ear wax removal waiting times

A charity that campaigns for deaf people has said it is concerned about the numbers able to access ear wax removal on the health service.

Traditionally ear-syringing was a service provided by GPs.

However, since 2018 removal of ear wax is no longer on the list of core services that surgeries must offer.

Hearing loss charity RNID said it was important the services were accessible and that not everyone could afford the option of paying privately.

The Health and Social Care Board (HSCB) said if a GP could not provide ear wax removal through the use of an electronic irrigator or micro-suction, they should refer the patient to a health trust.

"Each of the trusts provide an ear wax removal or micro-suction service," HSCB said in a statement.

"However, rather than wait, patients may prefer to seek, and pay for, private treatment."

A local private clinic said it had had a 31% increase in the number of people paying to have ear wax removed since March 2020.

'You can't hear'

A 77-year-old County Down man said he believed that in future, the more money people had would determine how healthy they would be.

Cavan Granleese paid privately to have ear wax removed in his local opticians.

Mr Granleese said a build-up of ear wax affected his hearing.

"If your ears are full of wax then you can't hear," he said.

"If you are having hearing problems, deafness, you can't socialise with people properly because you are always trying to get them to repeat what they've said."

BBC News NI can reveal that in Northern Ireland's biggest health trust, Belfast, 536 patients are waiting for the service in Ear, Nose and Throat, a nurse-led service, with the longest wait at 24 weeks.

The trust said it would like to "sincerely apologise" to those waiting.

"This clinic has been affected by the ongoing impact of Covid-19 and a change in the way this service is delivered by some GP practices in primary care based on current NICE guidance," a spokesperson said.

"Ear wax removal is a potentially aerosol generating procedure and therefore our staff have had to put in place extra safeguards to protect patients and staff."

In the Southern Trust, 351 patients are waiting for a first nurse-led service, with an average waiting time of two years.

The Northern Trust has eight people waiting and the longest wait is 32 days - the service has only been operational for approximately a year.

The South Eastern trust said it has 189 routine new patients - the longest wait is from July 2019 without being offered an appointment. They also have 261 review patients, with a 12-month backlog.

In the Western Trust, wax removal is offered by an ENT specialist nurse "however this should be for patients in whom management in the community is contraindicated".

They said there was no specific waiting list for wax management or removal.

'Really important'

The RNID, which campaigns to make life inclusive for deaf people and those with hearing loss, has said ear wax removal should be provided on the NHS when there is a clinical need.

Franki Oliver, from the charity, said it had raised the wider issue with Northern Ireland's health minister

"From our understanding there has not been a huge amount of discussion with local people about what services are being commissioned and provided to them," she said.

"This could be because it's not deemed as important as other services - but it is really important that people can access these services because it can have such a transformation on somebody's life and it is so simple and quick to rectify."

Ms Oliver added the effects of wax build-up can be debilitating.

"The effects of the hearing loss, or not being able to wear your hearing aids, can cause people to become socially isolated, they may withdraw, they may not feel they are able to go out the same way they used to," she said.

"It can be embarrassing and in the long-term we know that unmanaged hearing loss can have links with falls or dementia, so it is so important that it is offered to those who need it."

Growing demand

Local optician Michael McCourt said he had recognised a need for ear wax removal among his patients.

Speaking from his premises in Holywood, County Down, he said hearing, like sight, was an essential service.

"We started off doing it in our Crumlin Branch, then here in Holywood and we are now doing it in seven different locations across Northern Ireland," he said

Mr McCourt said demand had grown over time and those who were struggling to hear wanted to get it sorted as quickly as possible.

"People need it, people are coming in with an issue, their ears are blocked, they're struggling to hear, sometimes with discomfort even in pain and they get it sorted," he said.

Micro-suction treatment has replaced syringing where GPs removed wax by injecting water into the ear with a large metal syringe.

But since the National Institute for Clinical Excellence or NICE - which approves treatments for the NHS - advised GP surgeries to use electronic irrigators or suction devices, many dropped the service.

There is a cost to going private - the treatment at private clinics or High Street opticians can cost between £65 and £80.

Whistling sound

Paul Clarke, 50, lost his hearing through meningitis when he was a child.

He wears a hearing aid, but at present there is a whistling sound as ear wax is causing interference.

As he is refusing to pay for treatment, Mr Clarke was placed on a hospital waiting list to have his ears checked.

That was in August and he has not been contacted since.

He said he was "reluctant to go private" as he believed it is a public service that should be available to everyone.

Mr Clarke is critical of the lack of publicity around the service being withdrawn from many GPs' surgeries and said people needed to be made aware.

"I lost my balance and fell. I contacted the GP who checked my ears, he gave me two options to either go private or go on a waiting list with the health trust," he said.

Mr Clarke said there were a lot of people who could not afford to go private as it was very "expensive and if you have to go privately the cost would all mount up".

Source: Marie-Louise Connolly & Catherine Smyth, BBC News NI health team