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Walk in or call
Bring your child to Qrystal Pharmacy — no booking needed. Tell our team it's for a Pharmacy First earache consultation.
NHS Pharmacy First · Earache
Free NHS treatment for children's earache.
If your child is pulling at their ear, has a temperature, or is in pain, our pharmacists can assess acute middle-ear infection (otitis media) and treat where clinically appropriate. Free on the NHS for children aged 1 to 17.
- Free consultationCost
- Same dayWait time
- Children 1-17Eligibility
What is acute otitis media?
Acute otitis media is an infection of the middle ear — the small space behind the eardrum. It's especially common in young children, partly because their Eustachian tubes (connecting the ear to the throat) are shorter and angled differently. Most cases follow a cold and improve within 3 days, with or without antibiotics.
Under the NHS Pharmacy First service, our pharmacists at Qrystal Pharmacy in London can assess your child's earache, examine their ears with an otoscope, recommend pain relief and self-care, and prescribe antibiotics where clinically appropriate — for children aged 1 to 17, without a GP appointment.
Antibiotics make a modest difference for most ear infections — they typically reduce symptoms by less than a day. The pharmacist will use NICE guidance to decide whether they're likely to help in your child's specific case, which depends on age, severity, and how long symptoms have lasted.
Symptoms of a middle-ear infection in children
Earache can be hard to spot in younger children. Common signs include:
- Ear pain (older children may complain; younger children may pull or rub at their ear)
- A high temperature (38°C or above)
- Being more irritable than usual
- Difficulty hearing or asking for things to be repeated
- Crying or being unsettled, especially when lying down
- Trouble sleeping
- Loss of appetite
- Discharge from the ear (clear, yellow, or bloody)
- Cold-like symptoms in the preceding days
- Loss of balance or seeming unsteady
When to see us — and when to seek urgent help
Walk in to Pharmacy First if your child has:
- Ear pain lasting more than 24 hours that isn't settling with pain relief
- Discharge from the ear (which often means the eardrum has perforated)
- A high temperature alongside ear pain
- Symptoms in both ears (bilateral infection)
- Symptoms that worsen rather than improve
Get urgent help (NHS 111 or A&E) if you have:
- Swelling, redness, or pain behind the ear
- The ear sticks out from the side of the head more than usual
- Severe headache, stiff neck, or sensitivity to light
- Confusion or unusual drowsiness
- A child who looks very unwell, is floppy, or has a non-blanching rash
Who is eligible for earache treatment under Pharmacy First?
- Children aged 1 to 17 (the service age range)
- Registered with an NHS GP in England
- Acute earache likely due to middle-ear infection
You're not eligible if:
- Babies under 1 year old (please contact your GP or NHS 111)
- Adults over 17 with earache (we can advise but may refer to GP)
- Children with foreign bodies in the ear, suspected mastoiditis, or other red-flag features
- Children with grommets — please discuss with your GP first
How the consultation works
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Otoscopy in private
Our pharmacist takes your child's history and examines both ears with an otoscope in our private consultation room — usually 10-15 minutes.
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Treatment plan
You'll get a clear plan: pain relief and watchful waiting in most cases, or antibiotics (typically amoxicillin) where clinically appropriate.
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Records to your GP
With your consent we share a consultation summary electronically with your child's GP for joined-up records.
What's included
- Clinical assessment and otoscopy by a registered pharmacist
- Private consultation room — fully confidential
- Age-appropriate pain-relief advice (paracetamol/ibuprofen dosing)
- Antibiotic prescription where clinically appropriate
- Self-care and red-flag advice for parents
- Onward referral to GP, NHS 111, or A&E if needed
- Electronic record sent securely to your child's GP
Other Pharmacy First conditions we can treat
Sore Throat
Adults & children 5+
Same-day NHS assessment using the FeverPAIN score for adults and children aged 5 and over.
Read moreSinusitis
Adults & children 12+
Acute sinus pain and pressure assessed and treated for adults and children aged 12 and over.
Read moreImpetigo
Adults & children 1+
Same-day topical or oral antibiotic treatment for impetigo rash, from age 1.
Read moreChildren's earache — frequently asked questions
Will my child be given antibiotics?
Not necessarily. Most ear infections clear up within 3 days without antibiotics, and they only modestly speed recovery. NICE recommends antibiotics mainly for children under 2 with infection in both ears, children with ear discharge, or those who are very unwell or not improving after 3 days. Our pharmacist will decide based on your child's specific situation.
How long does a middle-ear infection usually last?
Most children improve within 3 days. Hearing can take a few weeks to return fully to normal, even after pain settles. If symptoms persist beyond 3 days or worsen, come back and we'll reassess.
What pain relief can I give my child?
Paracetamol or ibuprofen at age-appropriate doses are the most effective. Don't use both at once unless advised — alternate them if needed. A warm (not hot) flannel held against the ear can also soothe. Never put cotton buds or drops in the ear unless specifically prescribed.
My child's ear is leaking — is that bad?
It usually means the eardrum has perforated to release pressure. While it sounds dramatic, it's quite common, often relieves pain, and almost always heals on its own within 2-4 weeks. Come and see us — discharge is one of the situations where antibiotics may be helpful.
Should I keep my child off school?
Children with earache can usually attend school as long as they feel well enough — there's no contagion risk from the ear infection itself. If they have a fever or are otherwise unwell, keep them home until they recover.
Why does my child keep getting ear infections?
Recurrent ear infections are common, especially in children under 5, those in childcare, and those with allergies or family history. If your child has had 3+ episodes in 6 months or 4+ in a year, we'll discuss GP referral — they may benefit from grommets or further assessment.
Can my baby (under 1) be seen here?
Under the Pharmacy First service, the earache pathway is from age 1. For babies under 1 with suspected ear infection, please contact your GP or NHS 111 — they need a clinical examination by a doctor.
What about swimmer's ear (outer ear infection)?
Swimmer's ear (otitis externa) is different from middle-ear infection — it affects the canal, not behind the eardrum, and needs different treatment (usually antibiotic ear drops). Our pharmacist will recognise this and either refer to the GP or — for adults — supply ear drops privately.
Worried about your child's ear?
Walk into Qrystal Pharmacy for a free NHS Pharmacy First earache consultation — same day, no GP appointment needed.