There was an increasing number of patients on the Ear Nose and Throat (ENT) waiting list with impacted wax who were unable to progress to audiological assessment for hearing aids. The aim of the improvement was to reduce ENT waiting list, engage practices in the correct referral criteria for removal of impacted wax and provide a cost effective and efficient service that improves the flow of patients through primary and secondary care. We also wanted to ensure that patients are accessing the most appropriate specialist first time We achieved a combined capacity of 4,160 appointments per annum with approx. 2,000 patients seen from the ENT waiting list. This resulted in a £42k cost savings to the service and a waiting list reduced from 7 months to 4 weeks. For further information, please contact: Eluned Evans, Cwm Taf University Health Board (Eluned.email@example.com).