Ear wax removal is considered to be a regulated activity that falls within the scope of regulation by Care Quality Commission if the following criteria are met: the person and a listed healthcare professional both agree there is a problem that needs an intervention; and the treatment is carried out by a listed healthcare professional. The Government would encourage anyone accessing ear wax removal services to choose a professional that is a member of a statutorily regulated profession or registered with a voluntary accredited register listed on the Professional Standards Authority for Health and Social Care website.

I refer the Hon Member to the answer provided to the Hon Member for Stockton West on 5 February 2026 to Question 109250.

Integrated care boards (ICBs) are responsible for commissioning ear wax removal and audiology services that meet the needs of their local populations, taking account of relevant national guidance and local service arrangements.

NHS England is supporting ICBs and provider organisations to improve performance and reduce waiting lists for appointments and assessments for hearing services. This includes capital investment to upgrade audiology facilities in National Health Service trusts, expanding audiology testing capacity via community diagnostic centres, and direct support through a national audiology improvement collaborative.

Further, through the Medium Term Planning Framework, we have set a clear target for systems to reduce long waits for community health services. By 2028/29 at least 80% of community health services activity should take place within 18 weeks, including community audiology activity.

The Department has not made a formal assessment of the impact of a modern service framework (MSF) for hearing health on variation in access to audiology and ear wax removal services between integrated care boards (ICBs).

The Government's 10-Year Health Plan announced the development of MSFs to support more consistent, high-quality care, and to reduce unwarranted variation. After the initial wave of MSFs is complete, the National Quality Board will determine the conditions to prioritise for new MSFs as part of its work programme.

ICBs have a statutory responsibility to commission services that meet the needs of their local populations, including audiology services and, where clinically required, ear wax removal services. In exercising their functions, ICBs must have regard to reducing inequalities in access to, and outcomes from, healthcare services. Ear wax removal services should be commissioned in line with National Institute for Health and Care Excellence guidance.

The Department has not made a specific assessment. Integrated care boards have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local populations. Guidance for patients on ear wax build-up, including when to seek advice from a pharmacist or general practitioner, is available at the following link:

https://www.nhs.uk/conditions/earwax-build-up/

The Department has not made a specific assessment. Integrated care boards (ICBs) are responsible for commissioning local National Health Servies, including ear wax removal services, and must consider how best to improve population health and achieve best value for money.

ICBs commission these services in line with the recommendations for ear wax removal as set out in guidance produced by the National Institute for Health and Care Excellence, which is available at the following link:

https://www.nice.org.uk/guidance/ng98/chapter/Recommendations

Integrated care boards (ICBs) are responsible for commissioning local National Health Services, including ear wax removal services, and in doing so must consider how best to improve population health and achieve best value for money.

ICBs take account of relevant guidance on ear wax removal produced by the National Institute for Health and Care Excellence, which is available at the following link:

https://www.nice.org.uk/guidance/ng98/chapter/Recommendations

Integrated care boards (ICBs) are responsible for commissioning local National Health Services, including ear wax removal services, and in doing so must consider how best to improve population health and achieve best value for money.

ICBs take account of relevant guidance on ear wax removal produced by the National Institute for Health and Care Excellence, which is available at the following link:

https://www.nice.org.uk/guidance/ng98/chapter/Recommendations

Integrated care boards (ICBs) have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local population. This includes commissioning ear wax removal services in line with the recommendations for ear wax removal as set out in guidance produced by the National Institute for Health and Care Excellence (NICE), which is available at the following link:

https://www.nice.org.uk/guidance/ng98/chapter/Recommendations

This may involve commissioning general practices (GPs) or other providers, to whom GPs may refer patients, to provide ear wax removal services.

Manual ear syringing is no longer advised by NICE due to the risks associated with it, such as trauma to their ear drum or infection, so GPs will often recommend home treatment remedies to alleviate ear wax build-up.

However, in line with the NICE’s guidance, a person may require ear wax removal treatment if the build-up of earwax is linked with hearing loss. A GP may then refer the patient into audiology services, which ICBs are responsible for commissioning.

Integrated care boards (ICBs) have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local population. This includes commissioning ear wax removal services in line with the recommendations for ear wax removal as set out in guidance produced by the National Institute for Health and Care Excellence (NICE), which is available at the following link:

https://www.nice.org.uk/guidance/ng98/chapter/Recommendations

This may involve commissioning general practices (GPs) or other providers, to whom GPs may refer patients, to provide ear wax removal services.

Manual ear syringing is no longer advised by NICE due to the risks associated with it, such as trauma to their ear drum or infection, so GPs will often recommend home treatment remedies to alleviate ear wax build-up.

However, in line with the NICE’s guidance, a person may require ear wax removal treatment if the build-up of earwax is linked with hearing loss. A GP may then refer the patient into audiology services, which ICBs are responsible for commissioning.

Integrated care boards (ICBs) have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local population. This includes the arrangement of services for ear wax removal.

The current availability of self-referral and direct access to audiology services depends on local commissioning arrangements and service protocols, including ICB commissioning. Currently, self-referral to audiology services is usually for those with age related hearing loss.

NHS England is working with ICBs to support greater standardisation of self-referral arrangements and to assess opportunities to bring more of the self-referral process into the NHS App and website in future where appropriate.

The Department has made no specific assessment of services in Newbury because it is for integrated care boards to commission cost-effective healthcare to meet the needs of their local populations. Guidance for patients on ear wax build-up, including when to seek advice from a pharmacist or general practitioner, is available at the following link:

https://www.nhs.uk/conditions/earwax-build-up/

Integrated care boards (ICBs) have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local population. This includes the arrangement of services for ear wax removal.

ICBs are responsible for commissioning ear wax removal services in line with the recommendations for ear wax removal as set out in guidance produced by the National Institute for Health and Care Excellence (NICE), which is available at the following link:

https://www.nice.org.uk/guidance/ng98/chapter/Recommendations

Manual ear syringing is no longer advised by the NICE, due to the risks associated with it, such as trauma to their ear drum or infection, so general practitioners (GPs) will often recommend home treatment remedies to alleviate ear wax build-up.

However, in line with NICE guidance, a person may require ear wax removal treatment if the build-up of earwax is linked with hearing loss. A GP could then consider referring the patient into audiology services, which ICBs are responsible for commissioning.

When ICBs exercise their functions, including commissioning healthcare services such as ear wax removal, they have a duty to reduce inequalities between people with respect to their ability to access health services, and to reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services.

Ear, nose, and throat (ENT) services are one of five priority specialties identified in the Elective Reform Plan, published in January 2025, for significant transformation, due to the waiting times for ENT services. Given that a significant number of ENT referrals can be managed earlier and in a more convenient setting, we are exploring ways to expand community-based services so that patients receive quicker and more local care whilst reducing pressure on hospitals. The provision of earwax services will form part of this.

Integrated care boards (ICBs) have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local populations. This includes the arrangement of services for ear wax removal. When ICBs exercise their functions, including commissioning healthcare services such as ear wax removal, they have a duty to reduce inequalities between persons with respect to their ability to access health services, and to reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services.

Guidance for general practitioners (GPs) on ear wax removal is provided by the National Institute for Health and Care Excellence (NICE). Manual ear syringing is no longer advised by the NICE due to the risks associated with it, such as trauma to their ear drum or infection, so GPs will often recommend home treatment remedies to alleviate ear wax build-up.

However, in line with the NICE’s guidance, a person may require ear wax removal treatment if the build-up of earwax is linked with hearing loss. A GP could then consider referring the patient into audiology services, which ICBs are responsible for commissioning.

The Department has not engaged with the Birmingham and Solihull Integrated Care Board (ICB) directly on this point, but it is supportive of the ICB’s work to improve access to community-based services. All ICBs have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local population. This includes the arrangement of audiology services.

In line with NHS England’s work to improve access to primary care following the COVID-19 pandemic, all ICBs were asked to expand self-referral pathways for certain carefully considered community-based services by September 2023.

However, the Birmingham and Solihull ICB recommend visiting a pharmacist for blocked ears caused by ear wax rather than using the self-referral hearing check service. Ear wax removal services are not a core service included in the national GP Contract, and general practitioners often recommend home treatment remedies to alleviate ear wax build-up as manual ear syringing is no longer advised by the National Institute for Health and Care Excellence due to the risks associated with it, such as trauma to their ear drum or infection.

Integrated care boards (ICBs) have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local populations. This includes the arrangement of services for ear wax removal. When ICBs exercise their functions, including commissioning healthcare services such as ear wax removal, they have a duty to reduce inequalities between persons with respect to their ability to access health services, and to reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services.

Guidance for general practitioners (GPs) on ear wax removal is provided by the National Institute for Health and Care Excellence (NICE). Manual ear syringing is no longer advised by the NICE due to the risks associated with it, such as trauma to their ear drum or infection, so GPs will often recommend home treatment remedies to alleviate ear wax build-up.

However, in line with the NICE’s guidance, a person may require ear wax removal treatment if the build-up of earwax is linked with hearing loss. A GP could then consider referring the patient into audiology services, which ICBs are responsible for commissioning.

Integrated care boards (ICBs) have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local populations. This includes the arrangement of services for ear wax removal. When ICBs exercise their functions, including commissioning healthcare services such as ear wax removal, they have a duty to reduce inequalities between persons with respect to their ability to access health services, and to reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services.

Guidance for general practitioners (GPs) on ear wax removal is provided by the National Institute for Health and Care Excellence (NICE). Manual ear syringing is no longer advised by the NICE due to the risks associated with it, such as trauma to their ear drum or infection, so GPs will often recommend home treatment remedies to alleviate ear wax build-up.

However, in line with the NICE’s guidance, a person may require ear wax removal treatment if the build-up of earwax is linked with hearing loss. A GP could then consider referring the patient into audiology services, which ICBs are responsible for commissioning.

My Rt Hon. Friend, the Secretary of State for Health and Social Care has not made a formal assessment of the impact of differences in regulations on wax removal between registered nurses and non-registered practioners on patient care. The Department does not have plans to intervene in locally led arrangements for the provision of ear wax removal services. Integrated care boards are responsible for commissioning ear wax removal services in local areas in line with the recommendations for ear wax removal as set out in guidance produced by the National Institute for Health and Care Excellence.

Integrated care boards (ICBs) have a statutory responsibility to commission cost-effective healthcare to meet the needs of their local populations. This includes the arrangement of services for ear wax removal. When ICBs exercise their functions, including commissioning healthcare services such as ear wax removal, they have a duty to reduce inequalities between persons with respect to their ability to access health services, and to reduce inequalities between patients with respect to the outcomes achieved for them by the provision of health services.

Manual ear syringing is no longer advised by the National Institute for Health and Care Excellence (NICE) due to the risks associated with it, such as trauma to their ear drum or infection, so general practitioners (GPs) will often recommend home treatment remedies to alleviate ear wax build-up.

However, in line with the NICE’s guidance, a person may require ear wax removal treatment if the build-up of earwax is linked with hearing loss. A GP could then consider referring the patient into audiology services, which ICBs are responsible for commissioning.