Afew weeks ago, I had a call from my 87-year-old dad who lives in Thanet. He was contacted by a nurse – I’m not sure where she got his number from – offering to come to the house to check and irrigate his and his wife’s ears for £40. She showed them her card, which had her name and that she was a registered nurse.
As they didn’t have any ear wax, irrigation was not needed. They paid her £10 for her time. In a previous editorial (Brown, 2021), I wrote about the inequity of ear irrigation services, especially for our populations who are housebound, or who cannot afford to pay for private ear microsuction/irrigation and the adverse impact this has on vulnerable patients in our populations. As ear syringing is no longer one of the core services of the NHS, it has been moved to the category of a specialist treatment.
For as long as I can remember, general practice nurses (GPNs) provided free ear wax removal services, either ear irrigation or microsuction. Removing this service from general practice is putting vulnerable and older people at risk – although it is profitable for others – with possible unsafe service, whether practitioners are registered or not!
Local commissioners remain responsible for arranging the provision of medical services to meet the needs of their local population; however, not all patients requiring this service are having their needs met. Is this fair for our patients?
For a safe, equitable, accessible ear wax removing service, microsuction is the best choice. However, there are cost, staffing and training implications, and equipment is needed to complete the procedure. While ear irrigation has a higher risk of tympanic membrane perforation, litigation and discomfort in comparison, this remains a feasible option to remove ear wax, although it may be contraindicated in some people. However, this will require updating current equipment and strengthening the governance around the procedure and staff training.
This not only concerns me as a worried daughter but also as a clinician. Ear irrigation concerns have been raised with the NHSE Director of Nursing and Quality (London region) who has listened and is formulating a plan. I will keep you all updated.
Please share what is happening in your area around ear irrigation services. Together we are one voice and can make a difference to our patients. Get in touch at pn@markallengroup.com
Practice Nursing provides nurses working in general practice with the tools to reach their full potential and deliver the best possible care to their patients. Our monthly journal informs and inspires by providing up-to-date, evidence-based clinical articles, highlighting key professional issues and promoting the latest research in general practice.