Asked by: Andrew Selous (Conservative - South West Bedfordshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the latest NICE guidance is on water syringing for the removal of ear wax.
Answered by Edward Argar - Minister of State (Ministry of Justice)
Manual ear syringing is no longer advised by the National Institute for Health and Care Excellence (NICE) due to risks associated, such as trauma to the ear drum or infection.
The NICE guideline on the assessment and management of hearing loss in adults includes recommendations on ear wax removal. The guidance suggests considering ear irrigation using an electronic irrigator, micro suction, or another method of earwax removal such as manual removal using a probe. Pre-treatment wax softeners are advised for use before carrying out ear irrigation. NICE’s guidance is available at the following link:
https://www.nice.org.uk/guidance/ng98/chapter/Recommendations#removing-earwax
Asked by: Catherine West (Labour - Hornsey and Wood Green)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will provide people on low incomes with financial assistance to pay for the removal of earwax build-up.
Answered by Edward Argar - Minister of State (Ministry of Justice)
General practitioner (GP) practices offer National Health Service ear wax syringing services if they consider it clinically necessary or the patient will be referred to an appropriate local NHS service depending on the arrangements in place in the local area. The NHS would not charge eligible patients who need this treatment. GP practices are increasingly recommending self-care methods as the primary means to support the safe removal of ear wax. Local commissioners are responsible for meeting the health needs of their local population and should continue to ensure there is appropriate access to ear wax services.
Asked by: Munira Wilson (Liberal Democrat - Twickenham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential merits of providing ear wax removal procedures on the NHS for (a) pensioners and (b) people on low incomes.
Answered by Edward Argar - Minister of State (Ministry of Justice)
NHS England and NHS Improvement recognise manual ear syringing is no longer advised by the National Institute for Health and Care Excellence due to risks associated, such as trauma to their ear drum or infection. General practitioner (GP) practices are increasingly recommending self-care methods as the primary means to support the safe removal of ear wax.
However, if a GP practice considers removal clinically necessary, the procedure should either be undertaken at the practice or the patient should be referred to an appropriate service depending on the arrangements in place in the local area, including for pensioners and those on low incomes. Local commissioners are responsible for meeting the health needs of their local population and should continue to ensure there is appropriate access to ear wax services.
Asked by: Thangam Debbonaire (Labour - Bristol West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will reintroduce NHS ear wax syringing services.
Answered by Edward Argar - Minister of State (Ministry of Justice)
Decisions about the funding and provision of health services, including ear wax removal, are the responsibility of local clinical commissioning groups (CCGs). They should plan services to meet the needs of local communities including continuing to ensure there is appropriate access to ear wax services.
General practitioner (GP) practices are increasingly recommending self-care methods as the primary means to support the safe removal of ear wax.
However, if a GP practice considers removal clinically necessary, the procedure should either be undertaken at the practice, or the patient should be referred to an appropriate local service depending on the arrangements in place in the local area.
Asked by: Ruth Cadbury (Labour - Brentford and Isleworth)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what impact assessment his Department undertook on the removal of ear wax syringing as a core NHS service.
Answered by Edward Argar - Minister of State (Ministry of Justice)
It has not proved possible to respond to the hon. Member in the time available before prorogation.
Asked by: Andrew Rosindell (Conservative - Romford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what advice his Department has provided to (a) patients and (b) health professionals on the most appropriate alternative forms of treatment and support available in CCG areas where a decision has been made not to provide wax removal services on the NHS.
Answered by Edward Argar - Minister of State (Ministry of Justice)
Provision of ear syringing is an example of an enhanced service. Clinical commissioning groups (CCGs) make decisions about which enhanced services to offer based on the needs of the local population or value for money.
If build-up of earwax is linked with hearing loss, then general practitioners (GPs) can consider referring the patient into audiology services.
In areas where CCGs don’t provide wax removal services on the National Health Service, GPs are increasingly recommending self-care methods in the first instance as this avoids the risks associated with syringing, for example trauma to the ear drum/infection.
Asked by: Andrew Rosindell (Conservative - Romford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps is taking to help ensure that the NHS tariff price for ear wax removal is affordable.
Answered by Edward Argar - Minister of State (Ministry of Justice)
The national tariff is a set of prices and rules used by providers of National Health Service care and commissioners to deliver the most efficient, cost effective care to patients. To ensure tariffs are affordable, all NHS England and NHS Improvement prices are reviewed by stakeholders and clinicians to ensure that they are correct and relative to one another and that they reflect the differential amount of resource needed for different treatments or procedures. Their prices are set in reference to data sent from NHS trusts and then adjusted for efficiency and inflationary factors, and to fit within the envelope of funding available to nationally priced activity.
Asked by: Andrew Rosindell (Conservative - Romford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 24 September 2020 to Question 90063 on Earwax: Medical Treatments, what estimate his Department has made of the cost to the NHS of an (a) ear, nose and throat appointment for the purpose of removing wax, (b) an audiology appointment for the purpose of removing wax and (c) wax removal carried out in a primary care setting.
Answered by Edward Argar - Minister of State (Ministry of Justice)
In their nationally set prices NHS England and NHS Improvement have two prices for what is termed ‘Clearance of External Auditory Canal’. For both an ear, nose and throat and audiology appointment, the price is £127 for those under 18 years old and £103 for 19 years and over, regardless of speciality or setting.
NHS England and NHS Improvement do not set prices for primary care. No estimate can be provided of the cost of ear wax removal carried out in primary care settings. This is because ear syringing is not included in the GP Contract – it is an example of an enhanced service, and clinical commissioning groups are under no obligation to commission these. Some local commissioners have developed locally enhanced services (LES) so as to be able to offer to local practices supplementary services not already offered in the core practice contract, for which practices can seek funding. Some of these LES do include ear syringing.
Asked by: Andrew Rosindell (Conservative - Romford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, for what reasons earwax removal is no longer routinely available on the NHS; and whether he has made an assessment of the economic effect of that matter on (a) elderly and (b) hard of hearing people who rely on regular earwax removal.
Answered by Edward Argar - Minister of State (Ministry of Justice)
There are a range of services known as core services that all general practitioner (GP) practices are expected to provide and enhanced services that GP practices are commissioned to provide over and above this. The provision of ear syringing is an example of an enhanced service. If a local clinical commissioning group has decided not to commission an enhanced service, this may relate to population needs and value for money.
If the build-up of earwax is linked with hearing loss, then the GP practice could consider referring the patient into audiology services. The National Institute for Health and Care Excellence published guidelines in June 2018 on hearing loss at the following link:
https://www.nice.org.uk/guidance/ng98
This contains a specific section on earwax removal which is available at the following link:
https://www.nice.org.uk/guidance/ng98/chapter/Recommendations#removing-earwax
Asked by: Kevan Jones (Labour - North Durham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the training period is for a person to be trained to conduct micro-suction procedures for the removal of earwax.
Answered by Nadine Dorries
All private providers of procedures for the removal of earwax are subject to regulation by the Care Quality Commission (CQC), if the procedures are being conducted by, or under the supervision of, a healthcare professional.
All providers registered with the CQC have a duty to ensure they meet the relevant regulations as defined in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The CQC undertakes periodic inspections of all providers of regulated activities to ensure that the minimum standards of care are being met. The CQC will use its enforcement powers in cases where the standard of care falls below what is expected.
Information about the training period for a person to conduct micro-suction procedures is not held centrally.
Clinical commissioning groups are responsible for ensuring that they provide a comprehensive health service in their area, based on their assessment of local needs. The Department has no national plans to increase the provision of micro-suction procedures.