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CCGs ‘tightening access’ to surgery

CCGs ‘tightening access’ to surgery


Many CCGs have introduced new systems to restrict the flow of patients sent to hospitals, a BMJ investigation has revealed.

Released today, the investigation showed that thresholds for access to “low priority” surgery such as hernia and hip joints have been tightened.

Only four out of 211 CCGs have adopted new National Institute for Health and Clinical Excellence (NICE) guidelines to widen access to IVF treatment, leading to a postcode lottery across England.

Some doctors told the BMJ it should be up to NHS England to set national thresholds to ensure consistency.

Scarlett McNally, a member of the Royal College of Surgeon (RCS) council, told the BMJ: “Some of the procedures being termed as low clinical value are techniques that have been proven over years to be very helpful to most patients most of the time.

“If you’ve got a hernia, maybe you can wait a little bit longer [for surgery], but it causes discomfort, and there is a risk of having a bowel obstruction. That’s a much more major operation.”

Mid Essex CCG introduced a policy for restricting hernia surgery in March 2013, the Freedom of Information request revealed.

Eight CCGs across northwest London added restrictions for nasal surgery and a new general cosmetic policy, but also removed restrictions for asymptomatic gall stones and erectile dysfunction treatment.

Other CCGs have implemented new referral gateways to try to restrict the number of patients being sent to hospital.

A joint system put in place by NHS Chorley and Ribble CCG and NHS Greater Preston CCG will process all GP referrals, and is projected to save almost £50,000 across the two areas.

And a new gateway covering all musculoskeletal referrals across two CCGs in Staffordshire is targeting reductions of 209 cases a year in NHS Stafford and Surrounds CCG (designed to save £214,203) and 198 in NHS Cannock Chase CCG (designed to save £209 300).


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