The 17 surgery procedures which will be harder to get on the NHS in West Yorkshire

Routine medical procedures for a string of health conditions could become harder to get on the NHS when new rules come into force.

By The Newsroom
Friday, 4th January 2019, 9:24 pm
Updated Wednesday, 9th January 2019, 12:34 pm
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Health bosses in West Yorkshire and Harrogate are set to adopt national NHS guidelines covering 17 procedures deemed ineffective or unnecessary, a move expected to save almost £10m a year.

Four procedures used to treat adult snoring, heavy menstrual bleeding, knee problems and back pain will only be allowed in “exceptional circumstances”.

A further 13 interventions, including breast reduction, varicose vein treatment, haemorrhoid surgery and the removal of eye cysts, will only be offered when strict criteria are met.

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Health bosses have pointed out that the new rules will standardise access to the procedures, as their availability already varies between geographical areas, and that alternative treatments will be offered.

Guidelines covering the 17 procedures have been issued by NHS England and are being ratified by Clinical Commissioning Groups (CCGs), the GP-led organisations which control local health budgets.

The move will be discussed by at a meeting of the West Yorkshire and Harrogate Joint Committee of CCGs on January 8.

A report to the meeting said the new rules apply to procedures which “provide benefit to only a limited number of people, or which have been superseded by alternative interventions.

It said: “Introducing these policies will ensure that only the people who will benefit from these procedures are offered them. This will prevent avoidable harm to patients, avoid unnecessary operations, free up clinical time and ensure clinical practice in these procedures is evidence based.”

NHS figures show that there are currently around 880 carpal tunnel syndrome release procedures, used to treat pain and numbness in the hands, on Leeds patients each year. That would reduce by around 450 a year.

The new rules also cover chalazia removal, where people have cysts removed from their eyelids. The number carried out each year would fall from around 60 to 30 in Leeds.

In West Yorkshire and Harrogate, around 16,700 procedures covered by the “evidence-based treatment” rules are currently carried out annually, falling by an estimated 6,874 under the new rules. That would result in a cost saving of £9.38m. The report said: “however it must be remembered that for the majority of cases alternative treatment interventions will be offered which will partially or wholly offset the cost saving.”

It added: “Any savings arising from a reduction in referrals for the 17 interventions will be reinvested to provide appropriate interventions to better meet patient’s needs.”

The four procedures which may only be used in exceptional circumstances are:

Adult snoring surgery

Dilatation and curettage for heavy menstrual bleeding

Knee arthroscopy with osteoarthritis

Injections for nonspecific low back pain without sciatica

A further 13 will be subject to the new rules:

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 in adults

Ganglion excision

Trigger finger release in adults

Varicose vein interventions