The NHS are looking for opportunities to review all types of procedures performed across England. Such as the “Getting it right first time” team, in support with NHS England.

They intend to look at patient benefit / outcomes, and ultimately spend, when trying to decide how to allocate their budget such as the £114bn (2018/19) budget this year.

Clearly over the last few years the NHS has not been able to balance the books. The new injection promise of £20bn from the government could possibly make a difference. However, now they want to ensure spending only on necessary areas which they perceive have limited clinical value.

Who is effected?

They set out in July 2018 a 12-week consultation which identifies 17 surgical areas across 2 categories.

Category 1

Interventions which should not be routinely commissioned or performed

• Snoring Surgery (in the absence of Obstructive Sleep Apnoea (OSA))
• Dilatation and curettage (D&C) for heavy menstrual bleeding in women
• Knee arthroscopy for patients with osteoarthritis (washouts)
• Injections for nonspecific low back pain without sciatica

Category 2 -

Interventions which should only be routinely commissioned or performed when specific criteria are met (criteria included in the PDF file)

• Breast reduction
• Removal of benign skin lesions
• Grommets for Glue Ear in Children
• Tonsillectomy for recurrent tonsillitis
• Haemorrhoid surgery
• Hysterectomy for heavy menstrual bleeding
• Chalazia removal
• Arthroscopic shoulder decompression for subacromial shoulder pain
• Carpal tunnel syndrome release
• Dupuytren’s contracture release
• Ganglion excision
• Trigger finger release
• Varicose vein surgery

Where do you stand – for or against?

The NHS can only implement this if the consultation responses are either in support or they get no responses. Once again this has been published over the summer period, with now with only 8 days to go! You could be affected in a positive or negative way.

Alternative technology suppliers

You might have technology which provides a more clinical effective solution than the ones listed in the consultation. Therefore, you might want to review your value proposition, cost consequence models, or even health economics. So that you can better represent the argument for adoption of your innovation.

Or

Affected technology or service suppliers

You might be one of the technologies or suppliers to be part of the pathway, which is going to be affected. Therefore, you might want to submit information to counteract the argument for either reducing or removing this type of surgery.

To put this into context, the NHS is looking at reducing the level of procedures from approximately 348,201 to a range of 151,640 to 185,445 (44% to 53%).

The NHS now want to set design principles for:-

• Reducing the delivery of clinically ineffective interventions
• Interventions we should target initially and proposed clinical criteria
• Overarching goals
• Delivery actions including proposed new terms in the NHS Standard Contract.

They are seeking your views on the proposed policy and delivery programme, with a view to announcing the finalised programme later this financial year.

The clock is ticking and if you want to have your say, then if not already done so, click the link below and read the full consultation.

https://www.england.nhs.uk/evidence-based-interventions/

https://www.engage.england.nhs.uk/consultation/evidence-based-interventions/user_uploads/evidence-based-interventions-consultation-document-1.pdf

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