Wax Management Crisis: Audiology-Led Primary Care Earwax Removal Service

Welcome to part 3 of our 4 part mini-series about the UK’s earwax crisis.

We’re speaking to industry experts who have come up with innovative ways in their clinics for addressing the earwax problem.

In this episode, Julia speaks to Nicola Phillips, who is the Principal Clinical Scientist and Head of Primary Care Audiology at Swansea Bay University Health Board. 

Nicola and the team have come up with a system that enables patients with hearing, tinnitus or wax problems to be triaged directly to the Audiology Department – which then acts as the first point of contact, freeing up other general practitioners to see patients with more complex health conditions. 

Nicola would love to share her experiences so email her: [e-mail] 

Got a topic you think we should be talking about? Get in touch: [e-mail]

For more information about Signia UK and Ireland, visit their website

Sounding it Out by Signia, is produced by Annie Day from Fresh Air Production.

Full episode transcript

[00:00:00] Julia: Hello and welcome back to Sounding it Out, a podcast dedicated to audiology, brought to you by Signia UK and Ireland. I am Julia van Huyssteen, your host and Head of Audiology at Signia. This is the third episode of a miniseries about the wax management crisis we are facing here in the UK. In 2019, the British Medical Association decided it would no longer be considered part of the core services they were obliged to provide.

This has created a postcode lottery for patients suffering from ear wax. We've already spoken to the RNID or the Royal National Institute for Deaf People about their concerns. If you missed that conversation, you can go back and listen for free wherever you get your podcasts. We are also speaking to people in the profession who have come up with some innovative solutions.

Last time I spoke to Mark Newman, Head of Audiology at the Barking, Havering and Redbridge University Trust. He has managed to form an agreement with the CCG to fund their earwax management through reimbursement, which allows Mark's trust to have a full audiology lead wax care pathway.

[00:01:15] Mark: So sometimes you need to do a little bit of manoeuvring and ensure you're in the right meetings with the right people in order to make effective change.

[00:01:23] Julia: If you missed the conversation, you can go back and listen for free.

My guest today is Nicola Phillips, who is the Principal Clinical Scientist and Head of Primary Care Audiology at Swansea Bay University Health Board. Nicola, hello.

[00:01:41] Nicola: Hello. Thank you for having me, Julia.

[00:01:44] Julia: So my first question to you really is about a paper that you co-authored very recently, and that has been published in the BMJ or as it used to be called the British Medical Journal. That's so exciting and congratulations. I'm really pleased for you and this paper details a trial that you've been running at the University Health Board. Can you please give our audience an overview of this paper?

[00:02:07] Nicola: Yeah. Thank you Julia. We are delighted to get the first ever primary care audiology publication and myself and the team are very delighted about that. The title of the article is Approved on Healthcare and Practice, an Integration of Audiology Services into Primary Care. So back in 2016, delivering audiology in a primary care setting was set up as a pilot project within the health board. The main aim of the service being enabling patients with hearing, tinnitus or wax problems to be triaged directly to audiology, acting as the first point of contact.

And it greatly benefits the patients as they're seeing specialists in hearing care within a matter of weeks, whilst also freeing up important time for GP and practice nurses. And we do see the amount of referrals being sent to ENT in secondary care, which as we know is very costly.

[00:02:55] Julia: Thank you very much for that, Nicola. So I was actually lucky enough to come and observe this primary care approach in person a month ago or so, and although the service runs like a well-oiled machine, for the most part, it has taken, as you say, a long time to get to this point. I think you mentioned the start date of being 2016. In your opinion, why do you think it has taken this long?

[00:03:18] Nicola: I think, delivering an audiology service within primary care had never been done before. So we needed firstly research, primary care activity, and then start collecting as much data as