When it comes to ear syringing, GPs just won’t listen to reason


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By Beth Kennedy

02 Jul 2018

GPs’ reticence to provide ear syringing services presents an enormous opportunity for pharmacists, says The Pharmacist’s GP blogger Dr Livingstone

Blimey – GPs, what are they like? Obviously, I am one, so I should know. But just occasionally their/our mantra of being overworked starts to sound overwrought, and I’m left being faintly embarrassed by association.

And so it is with ear wax. Yes, that’s right. Ear wax. You’d think GPs would have other things to get aerated about but, apparently, it’s a hot topic at present and it’s the principle of the thing etc, etc.

To explain. NICE has recently come up with one of its less revelatory bits of guidance, stating that ear wax causing deafness should be managed, after due softening, with ear syringing ‘in primary care or community ear care services’.

Nothing contentious there, surely, apart from NICE possibly degenerating into the National Institute for the Bleedin’ Obvious. But that’s where you’re wrong. GPs are full of self-righteous indignation about ear syringing not being part of their ‘core contract’ and are therefore demanding funding to provide it as an enhanced service.

To which I have to say, without any sense of irony, ‘What?! Could you repeat that?!?!’

Now, it’s right and proper that we should stop the relentless workload-dump, but come on – ear syringing? This was one of the first things I learned as a GP trainee thirty-plus years ago, and has remained part of my ‘core service’ ever since, albeit usually delegated to the practice nurse.

In fact, I’d go as far as saying that syringing ears is one of the most satisfying and effective things we do in primary care – restoring to a patient one of their key senses is a darn sight more rewarding than sticking them on a statin. But not according to many of my outraged and overworked colleagues.

So if I were you, pharmacists, I’d exploit this fiasco by offering the service yourselves. Flog those ear drops, invest in an ear irrigator, get trained and clean up. Clearly, you’re unlikely to get any protests from GPs. And if you do, you’d be justified in turning a deaf ear.

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