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WHO is removing your ear wax?
- Dr Jeff
- Apr 25
- 3 min read
Updated: May 3
Ear wax removal: an unregulated landscape and popular side hustle amongst "non-experts"
Patients seeking ear wax removal will now struggle to be seen via the NHS following a widespread de-commissioning of this service. This has led to a huge shift of ear care provision over to the private sector. Likewise, patients who may have previously been seen via ENT for ear cleaning are often being told to go private, as departments continue to battle with long waiting lists, clinical priorities and staff shortages. As NHS staff aren't permitted to make recommendations about private healthcare providers, patients are left with the task of finding a suitably qualified clinician to remove their ear wax and provide any accompanying audiological advice/management.
This recent surge in demand for private ear wax removal has fuelled a rapid rise in the number of service providers; from high street audiology chains, to independent practices and individuals alike. So when it comes to choosing the right person for the job, patients should be asking one important question “WHO is removing my ear wax?”. Outside of the ENT department, you will most likely find audiologists and hearing aid dispensers offering ear wax removal services. These individuals should have (1) a degree level qualification in audiology or hearing aid audiology, (2) be registered with the HCPC or RCCP/AHCS (3) have appropriate liability insurance and (4) be competent in wax removal. Nurses providing such services are required to be registered with the CQC.
Ear wax removal training delivered by most clinical trainers is very brief and trainees can be out offering their own wax removal services with just a handful of wax removal attempts under their belt. This training pathway does seem to function providing that the trainee is already suitably qualified and experienced in audiology, works within the recommended scope of practice and has continued access to an experienced supervisor. After all, we all have to start somewhere, right?
For me what is most concerning is the number of ear wax removal providers who do not have the necessary background qualifications, otology experience, access to clinical support networks or (in some cases) even clinical registration. Alarmingly, a lack of hard regulation and blurred interpretation of national guidelines has signalled some unscrupulous clinical trainers to open the flood gates to a wider trainee demographic who work in areas far outside of ears. Whilst reputable trainers are choosing to be more selective by only allowing registered colleagues who are qualified to work in audiology on to their courses, others are not. Right now you can find beauty therapists, podiatrists, mental health nurses, chiropractors, dispensing opticians and physiotherapists (the list goes on) all offering ear wax removal services having attended a brief crash course in ear wax removal. This poses a serious risk to trusting members of the public not to mention imposing negative reputational damage to our profession.
To a naïve outsider, one may think that ear wax removal is just a simple extraction procedure and given the right circumstances, with the right expertise and equipment, it can be. However, to possess the appropriate skill and knowledge levels requires months of practice built on a sound pre-existing foundation of audiological experience. Simply being able to look in a patient's ear with an otoscope and recognise normal from abnormal takes many months of practice, equating to 100’s of ears. So the assumption that a insert any of the above professions here could attend a crash course in wax removal and come out as competent and able to deliver a reputable dewax service is just plain wrong. To think of it a different way, you wouldn’t see your optician for a back adjustment or your physiotherapist for an eye examination, so why should ear wax removal be seen any differently?
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