An overview of the rationale and benefits of the NHS Scotland Academy microsuction programme.
Andy Chin, Consultant ENT Surgeon, Clinical Lead for ENT - NHS Lanarkshire gives an overview of the rationale and benefits of the NHS Scotland Academy microsuction programme.
Unmanaged hearing loss caused by ear wax build-up can significantly impact quality of life, particularly in older adults. It is linked to reduced social engagement, poorer mental health, decreased physical activity, and a threefold increased risk of falls. Hearing loss from excess ear wax is also a known risk factor for dementia, contributing to social isolation and cognitive decline (Johnson et al., 2021)1. These effects are especially concerning in older adults with comorbidities such as cognitive impairment and chronic conditions.
Access to ear wax removal services is essential for maintaining hearing, wellbeing, and independence. Without it, individuals may experience pain, hearing loss, and delays in assessment or treatment, placing additional strain on NHS services. Although oil-based ear drops are a common first step, they are effective in only 20% of cases (RNID, 2024).
Professional ear wax removal is indicated when symptoms persist or when the ear must be cleared for examination, diagnosis, or treatment (NICE, 2018). As of January 2024, an estimated 2.3 million people in the UK require professional wax removal annually (RNID, 2024).
Microsuction is the preferred method of removal, offering a safer, faster, and more effective alternative to irrigation, which has several contraindications. However, there is a shortage of trained staff, limiting NHS capacity. Private providers have capitalised on this gap, charging £60–£100 per ear, or up to £200 for home visits. In some areas, HSCPs have resorted to signposting patients to private services.
To address this, NHS Scotland Academy (NHSSA) has launched a national ‘Train the Trainer’ programme to upskill Registered Nurses (RNs) in delivering microsuction ear care. This initiative aims to expand capacity, reduce health inequalities, and ensure consistent, high-quality training across Scotland.
Johnson, J.C.S., Marshall, C.R., Weil, R.S., Bamiou, D.-E., Hardy, C.J.D. and Warren, J.D. (2021). Hearing and dementia: from ears to brain. Brain, 144(2), pp.391–401. doi:https://doi.org/10.1093/brain/awaa429.