Page 28 - Primary Care Audiology

It is widely accepted that, given other pressures, practice nurses,
GPs, and ENT departments no longer have the capacity to meet this
need alone. Experts in the field also acknowledge that managing
earwax in uncomplicated ears is not the best use of ENT time and
that utilising secondary care is too costly for this intervention.

“Relying on hospital ENT [for wax management] causes a delay and
is an expensive and unnecessary use of specialist resources.”
Professor Kevin Munro, Ewing Professor of Audiology, NIHR
Manchester Biomedical Research Centre 60

This was especially true during the Covid pandemic when ENT
departments and GP colleagues had to prioritise managing high-
risk patients. As a result, the Royal College of General Practitioners
(RCGP) and the British Medical Association (BMA) recommended
that GPs signpost people with impacted earwax to primary care
audiology practices on the high street. 61

Our members responded to this call and today provide more than
300,000 de-waxing appointments each year, helping people access
the support they need in safe and effective clinical settings across
the UK. 62

Unfortunately, the NHS has been slow to capitalise on this service
shift, leaving huge gaps in NHS-commissioned services. People pay
£55 on average to access this care where it is not funded by the NHS,
worsening health inequalities for those who cannot pay. As the RNID
has reported, many regions in England lack a funded NHS de-waxing
service, disadvantaging millions of people. 63

Worst still, in some regions, NHS commissioners continue to require
patients to visit their GP for a referral to ENT to remove earwax. This
pathway can cost the NHS three times as much as it costs people to
fund their own care in primary care audiology closer to home. 64

28 NCHA Primary care audiology – accessible ear and hearing care for all 29