The chief executive of the Company Chemists’ Association (CCA) has suggested Pharmacy First could be expanded to help fill gaps in NHS earwax removal provision in England.

Recent research by the Royal National Institute for Deaf People (RNID) found that fewer than half of integrated care boards (ICBs) provide full earwax removal services in line with guidelines from the National Institute of Health and Care Excellence (NICE).

In response to the research, Malcolm Harrison, CCA chief executive, pointed out that pharmacies already provide advice and support for people experiencing a build-up of earwax, highlighting self-care options where appropriate.

However, Mr Harrison also suggested that community pharmacies could be commissioned to deliver earwax removal services on behalf of the NHS through an expansion of the incoming Pharmacy First service.

He said: ‘Pharmacy First shows the potential of the community pharmacy to provide more hands-on care to patients.

‘Earwax removal could be the type of activity that could be considered as part of future expansions of the Pharmacy First service.’

The RNID’s research found that seven ICB do not commission earwax removal at all, affecting access for up to 9.8 million people.

The charity’s freedom of information requests to all 42 ICBs in England revealed that 18 of them commission full earwax removal services in line with NICE guidelines.

Partial services are offered by 15 ICBs, with the majority providing earwax removal only within limited areas inside their geographical footprint.

In some areas where the service is commissioned, not all general practices choose to deliver it, the RNID found. Some ICBs also have restrictive criteria, such as only offering the service to people over 55 – which, according to the charity, goes against NICE guidelines.

Mr Harrison of the CCA said an expansion of the Pharmacy First service to include earwax removal ‘would help improve patient access and reverse the postcode lotteries of provision that the RNID has uncovered’.

Though speaking at the end of 2023, pharmacy minister Dame Andrea Leadsom said there were, at the time, ‘no plans’ to add to the seven common conditions covered by the incoming Pharmacy First service.

NHSE confirmed last week that Pharmacy First would be launching on Wednesday 31 January 2024 as planned, with more than 10,000 pharmacies having signed up to deliver the service so far.

It will see community pharmacists in England offering advice and treatment for seven common conditions – sinusitis, sore throat, earache, infected insect bite, impetigo, shingles, and uncomplicated urinary tract infections in women – under a nationally commissioned service utilising patient group directions (PGDs).

Alastair Buxton, director of NHS services at Community Pharmacy England, noted that many pharmacies are now offering a private service to remove earwax, and some services have been commissioned by the NHS at a local level, but he also suggested that pharmacy provision could go further.

He said: ‘Subject to the right funding and support being provided, community pharmacies could provide earwax removal services to help give people access to a key service close to home, and take pressure off GP surgeries.’

Mr Buxton added: ‘Making a pharmacy earwax removal service more widely available on the NHS in the future would align with the Vision for Community Pharmacy which recommends widening the scope of pharmacy in the prevention arena, helping to position pharmacies as local health and wellbeing hubs.’

According to figures from the RNID, 2.3 million people in the UK require professional earwax removal every year.

A version of this article first appeared on our sister title Nursing in Practice