Doncaster health bosses crack down on operations

Preparing for an operation
Preparing for an operation

Health bosses have moved to stop a number of operations and procedures from being routinely available to Doncaster patients on the NHS.

NHS Doncaster Clinical Commissioning Group has drawn up a list of procedures, which are judged to have ’limited clinical value’.

They will start to come into effect this month, following a review of national and regional treatment guidelines by local GPs and hospital clinicians.

Procedures will not be stopped altogether but they will only be funded when appropriate for the patient, after certain ‘thresholds’ have been met.

The affected procedures are: non-cancerous skin lesion, removal of the gall bladder, Interventional treatment for haemorrhoids, hernia repair, cataract surgery, hip replacement for osteoarthritis, knee replacement for osteoarthritis, carpal tunnel syndrome, common hand conditions, and acupuncture for low back pain and sciatica.

It is likely to mean that moles will no longer be removed by the NHS for cosmetic reasons, and acupuncture will not be given for low back pain and sciatic.

Patients who are currently on a waiting list to have any of the procedures will not be affected - the changes only apply to new referrals.

Dr David Crichton, a GP and chairman of NHS Doncaster Clinical Commissioning Group, which organises and pays for NHS services in the borough, says it should mean the people in most need of ‘necessary’ operations will get them more quickly.

He said: “It’s important that we follow agreed best practice and only fund treatments that are proven to be clinically effective and expected to significantly improve a patient’s health and well-being.

“Unfortunately, some operations and treatments that we have been paying for do not meet these criteria and have been found to give limited clinical value to patients.

“We have agreed with Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust – which carries out most of the procedures on Doncaster people – a set of clinical thresholds that must be met before a GP or other clinician can refer a patient for an operation or treatment.

“A threshold could, for example, be that medication is tried first to manage a health problem. Medical experts agree that surgery has risks and for many conditions should only be considered after trying other, reasonable, non-surgical options first.”

In some circumstances, a doctor may think the patient has exceptional clinical circumstances and may benefit from a treatment not routinely provided. They can make an application on the patient’s behalf, which will be considered by an independent panel.

Dr Crichton added the NHS in Doncaster is trying to manage a rising demand for services from a finite workforce and funding.