Ear syringing on the NHS

[Spidey66]

Also posted in health.
Went swimming a few days ago, and now my ear is blocked. Its painful, im deaf, and it's ringing. I've been putting olive oil drops in it and if anything its worsening.

I've had this before, and whats always sorted it has been syringing.

I went to a minor injuries/walk in yesterday because the pain was getting worse to be told the NHS no longer do syringing. The NICE guidelines now recommend micro suction for blocked ears but this is only done privately. Instead the NHS will refer to audiologists for hearing aids.

Hearing aid referrals for blocked ears? Come again? I'm only deaf for want of a brief intervention!

This is ridiculous!

Should ear syringing or an alternative be available on the NHS? Yabu = no go and pay for it. Yanbu= ear syringing or an alternative should be available on the NHS

@Spanielsarepainless

My mother, paid yesterday. She asked what happened if people couldn't afford it and was told an 18 month wait via NHS audiology. Good luck with telephone triage, then.

18 months to clear a blocked ear?! Bloody hell the system is broken!

I suffer from blocked ears a lot as my body just makes a lot of ear wax. Going around for 3 weeks deaf in one ear recently whilst waiting for them to be syringed was torture, couldn’t hear, bumping into things. Making someone wait 18 months for a small, easy procedure is ridiculous. I can’t ever imagine having to cope being dead in one ear for that long!!

yabu
microsuction is safer than syringing and the audiologist also has a good look into your ear and can refer you on if they observe issues.

many opticians now have audiologists that provide microsuction.

yanbu I think this is a basic thing that the nhs should be able to provide.

and anecdote - dh had bad earwax and needed syringing each year.
however since he had it suctioned about 10 years ago his ears have not blocked up again.

@Demelza82

I recently had a blocked ear, I remedied it myself by softening it myself with olive oil then using a earex ear bulb to flush it. Not difficult

Good for you, but…. I have had a period of 3 years where my ears kept blocking and got recurring ear infections. The frequency increased until it was happening once per month for 7-10 days of agony. The bulb flushing was recommended by one locus GP over the phone without any physical checks. it actually caused even more issues as I have eczema like skin condition and actually needed to have kept my ears dry not soak them with water. I tried Ortex which could sometimes help. I was also being prescribed on repeat Otomise which GP was handing out like smarties to me despite not supposed to be doing this without further testing. Since lockdown the GPs just refused to see me to do an examine. I now have permanent Tinitus. Eventually in frustration I paid to see private ENT. He microsuctioned my ears which took a long time, said they were in a bad way. Gave me an open appointment to come back when infection reoccurs to investigate causes from scratch with swabs etc. That was 9 months ago- not one problem since. Micro suction works. It could have saved me 3 years of agonising ear ache and prevented me from developing tinitus. I never had significant issues with my ears blocking and ear ache until I reached peri menopausal stage. It is very common to get worse as you become menopausal apparently due to skin changes IMHO you sound smugly blasé- people suffer for years in agony and all because GPs don’t take it seriously. Bulging and olive oil may solve minor occasional issues with built up wax, but it most certainly does not help people with significant issues.

Bulging=bulbing

You need to pay for private microsuction ASAP. Otherwise that stuck water could turn into an infection. You cannot and will not get it on the NHS. The NHS is broken.

Have you tried Otex ear drops, to melt the wax. They are very good, they work and once they’ve melted the wax you’ll get the water out hopefully.

A trip to your local pharmacy and a fiver invested in Otex is my recommendation.

Blissfullife Poor you! Hope you feel better now.Had a dreadful ear infection on a long flight ,pain indescribable .Like you ,I have to pay £55.00 per ear at a private clinic now .Dont understand their reasoning .How is having blocked ears not a medical problem FFS!

So this happened to my FIL 81. Lived alone, needed ears syringing as couldn’t hear. I arranged it privately but there was a week’s wait. So the govt thinks it’s saved money.

No - because fils brother also in his 80s called him repeatedly and FiL couldn’t hear the phone. So brother called the emergency services to check on fil, thinking he’s laying dead in his house with nobody realising. Cue blue lights from police/ambulance in fil’s driveway and a visit. Total waste of public funds - could have been avoided had they sorted his fucking ears out when he begged!

Ridiculous. I've had mine syringed a few times over the years. Once on NHS by nurse, other times privately as there is no way I'm waiting 7-10 days being deaf and not being able to work and look after the kids properly. In all times the relief has been instantaneous...15 mins and I hear perfectly again. The drops have never worked for me. They don't understand the distress it causes, I'm partially deaf so it's not just muffled it's complete deafness.

Go to spec savers it cost £30 for 2 ears .

@Guacamole001

Hopi ear candles done priva tely is an option.

Don't do this, evidence has shown it to be ineffective and dangerous.

I don't think people should have to pay for this service. I understand why syringing has stopped, microsuction is a much better solution, but I don't understand why that isn't provided on the NHS. Even if GPs can't offer the service, it should be commissioned and provided elsewhere to those in medical need.

@bunnybuggs

This has been the case for so many years (at least the last 5) - so I cannot understand why you are getting so worked up about it. I have difficult shaped ear canal and do my own wax-softening and gentle syringing (believe me as you get older this becomes more of a problem). Some patients are unable to see medical staff face to face for serious problems and you want your ears seen to. YABVVU

Having thought about it...I've had surgery twice this year on the NHS, both deemed ''minor.'' I've had my gallbladder out. I'd been suffering off the scale pain for over two years with this, with A&E trips, paramedics everything. By the time it came out, I had over 200 gallstones in there, at which point the surgeon lost count. The average is about 5 or 6. Next stage could have been life threatening infections or complications if it had not come out.

I've also had the first of two cataracts operated on (waiting on the 2nd.) Before I had the first one done, my eyesight had deteriorated to the point I had to go off sick as I was unsafe and making all kinds of mistakes at work. I work for the NHS myself as a mental health nurse. a service already on it's knees. Neither the opticians nor Occupational Health could do anything until at least one was done. Now I've had one done, it's improved to the point I can work effectively.

However, by your mindset I should not have had these treatments because may people have not been seen face to face!

Better minor treatments seen and treated early if it prevents longer term damage and impact further down the line, surely?

And yes of course I appreciate the service I've had. I'm eternally grateful the NHS have sorted me out, especially with the pandemic.

Oh and of course I understand that treatments change and evolve and that if ear syringing is now not seen as safe it should be replaced with something more up to date and in line with evidence based practice. If micro suctioning is the way forward, it should be offered routinely on the NHS. That's why I said in my OP 'ear syringing or an alternative should be offered.'

I get that micro suction is safer, but if that's the case they need to invest in it, rather than expect the patient to pay for it. Blocked ears are a common complaint, there should be NHS treatment for it

The NHS is still struggling through the backlog of urgent cases from the pandemic. Microsuction of ears is a skilled procedure usually done by an ENT doctor, so even if referred you could be on the waiting lists for 18 months or longer.

Enough GP time is already taken up with minor issues people can treat at home, eg ear wax (use drops or pay)
Sore throats (buy some lozenges)
Thrush (buy the cream and oral tablet from the pharmacy)
Warts/veruccas (treat or freeze at home)
In-growing toenails (see a podiatrist or learn how to reverse the problem before it gets bad).

Ear syringing hasn't been part of the core GP contract since at least 2004 which is when the last major rewrite was.

Surgeries shouldn't be offering this - they aren't funded or commissioned to provide this (unless there is a locally enhanced service or LES for this - these are very uncommon).

If there is no mechanism for ear wax removal complain to your CCG.

Personally I think it's about time that GPs stopped doing the stuff that we're not funded for and focused on core work.

It may depend on the nhs service in your area. The ent dept I work in has a nurse led microsuction service. They usually ask that patients use olive oil/soda bicarbonate drops to soften/breakdown the wax to make suction easier. It can take sometime for the drops to work. We also run a rapid access clinic but that's usually for emergency apps, but alongside that are nurse slots at the end of the rac clinic. Your gp can refer and can contact the dept direct for advice and information. If you feel there's oil trapped behind the wax it's not unreasonable for a more experienced person to have a look. I would suspect that after this issue is resolved it would be suggested that you use drops once a month to help the wax work it's way out. Wax is a good sign your ear is healthy and may just need a bit of a clear out every few months.

I should add our waiting list is long due to 2 staff having left. We've released our specialist nurse to solely work on the nurse led service, and are training up our new senior nurse.

My mother couldn't get it done on the NHS and had to pay.

Her local hospital would do it, but only if referred by a GP and her GP refused to refer her, presumably because it would come out of their budget.

You can do it yourself. I was a little miffed at first when the doctor said to do that but now feel it’s perfectly normal and would no more ask them to it than I would ask them to put a plaster on a cut.

I've just seen your update about being a mental health nurse. We often see people more quickly when it is a problem that impacts work. Go to occupational health and see if they can push this further.

If it's outdated, fine, but if there are safer alternatives they should be widely available on the NHS

Quite. A blocked ear is something the NHS should be treating, therefore the treatment for it should be available.

That said, I had a terrible blocked ear and rang the surgery who called me in. The Dr looked at it and prescribed the sodium bicarbonate eardrops which cost about £3 and worked brilliantly even though I was almost entirely deaf in one ear it was so blocked up. I was considering paying for micro-suction myself but it was unnecessary, so I can see why the NHS is reticent to pay for it too.

I've had syringing before and it was unbelievably painful. And I came down with an ear infection the following week which the nurse prescribing the antibiotics said was probably due to the syringing.

In Wales the suction hasn't stopped just paused due to covid, as with most ear related stuff. Emergency hearing aid fix is great though. Had to go private for ear wax removal against my principles but with no start date on NHS I could not wait any longer.

@TheWeatherWitch

Have you tried Otex ear drops, to melt the wax. They are very good, they work and once they’ve melted the wax you’ll get the water out hopefully.

A trip to your local pharmacy and a fiver invested in Otex is my recommendation.

I suffer from regular ear wax. Every time I've used Otex or similar, it causes and infection. That means a consultation with the GP. They always try a spray first, which never works, and as the infection gets worse, another GP appointment, and finally get antibiotics.

None of that happened when the practice nurse used to do the ear syringing.

So, the NHS thinks they save a bit of money by not doing the simple/cheap procedure, but it ends up using up 2 GP appointments and 2 prescriptions. It's madness.

@StrangeToSee

I get that micro suction is safer, but if that's the case they need to invest in it, rather than expect the patient to pay for it. Blocked ears are a common complaint, there should be NHS treatment for it

The NHS is still struggling through the backlog of urgent cases from the pandemic. Microsuction of ears is a skilled procedure usually done by an ENT doctor, so even if referred you could be on the waiting lists for 18 months or longer.

Enough GP time is already taken up with minor issues people can treat at home, eg ear wax (use drops or pay)
Sore throats (buy some lozenges)
Thrush (buy the cream and oral tablet from the pharmacy)
Warts/veruccas (treat or freeze at home)
In-growing toenails (see a podiatrist or learn how to reverse the problem before it gets bad).

Trouble is that GPs end up having to treat those things once they turn more serious. So them refusing to treat them at the early stages, with simple/cheap treatment, often causes more GP appointments and more treatments at a later stage!

As for ingrown toe nails. My son has been plagued with them. We knew, from the outset, that a podiatrist was the answer (I've suffered in the past), but the GP wouldn't refer and insisted we get "treatment" from the practice nurse, who hadn't a clue. We had countless appointments with the generic advice of salt baths, antiseptic cream, etc (we can read the internet too!), but they just go worse and ended up with infections, thus needing antibiotics. Eventually, GP relented and referred to podiatry and the offending toe nails were removed within a couple of weeks. Again, by not treating/referring properly in the first place, numerous GP/nurse appointments were wasted that didn't actually resolve the issue.