When my husband recently tried to access the ear wax removal service previously provided by the local hospital, he was told he would be charged. This unexpected barrier to essential care previously provided free by the NHS was challenged successfully and is a salutary lesson.
In the area covered by the Herefordshire and Worcestershire Integrated Care Board (ICB), the local Acute Hospitals NHS Trust has recently changed its NHS Hearing Service provision, for patients aged 50 and over who have been identified with non-complex age-related hearing loss, away from the Audiology Department in our local community hospital.
The ‘Change in hearing service provision’ letter states: ‘From 31 December 2023, your care will need to be transferred to a new provider. This will allow you to access free hearing services as and when you require it. You will be able to select a provider of your choice from a list of accredited and qualified providers in your area’.
These providers include private organisations. One called ‘Audiological Science Ltd’ operates from GP practices elsewhere in the county although not in our town. My husband, who falls into the affected category and, following an unsuccessful attempt at self-management of ear wax removal, he made an appointment. *
The audiologist agreed that microsuction would be helpful but said there would be a charge for this service. I pointed out that according to the transfer of service letter and our ICB NHS policy document of April 2024 (‘Ear Canal Clearance Guidance’) this service must be provided free of charge.
The audiologist rang her manager who agreed that on this occasion the service would be free but that they would need to check the policy. The audiologist then carried out the procedure.
I subsequently put a complaint into the ICB asking whether other patients were being charged for a service that had already been paid for by the commissioning authority (the ICB) or was it simply a failure to communicate the policy to new providers?
The response from the ICB’s chief executive officer included an apology and stated:
‘Your concerns were shared with the senior contract manager… as well as with the Head of Audiological Services at Audiological Science Ltd. They have confirmed that microsuction is included within the NHS care pathway, and as such they should not be charging patients for this service.’
Also included was an apology from Audiological Science Ltd.
‘To confirm, there is no charge to patients for wax removal under our NHS service… we have taken steps to reinforce the correct guidance across our team.’
These additional burdens on patients to check their own care pathways and their entitlement to free-at-the-point-of-use care causes unnecessary anxiety, adds to health inequalities and is an unwanted effect of privatisation by outsourcing – even if that service is supposed to be free for the patient.
Sylvia Chandler, retired GP and KONP campaigner
October 2025
*Ear wax removal is not available for younger patients throughout our ICB and, alongside the RNID’s campaign, we need to restore it in general practice. Some GP practices provide ear wax removal through a LES (Locally Enhanced Medical Services). But many practices no longer do so.
👉Read more here about the KONP working group on ear wax removal and the campaign against charging,
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