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Restrictions cause surgery ‘postcode lottery’

Restrictions cause surgery ‘postcode lottery’


Access to surgery is being restricted by primary care trusts (PCTs) creating a “postcode lottery”, research published in The Lancet suggests. 

The study found a significant difference in the number of surgeries being performed in PCTs across the country when comparing hospital data with primary care trust policies on surgery. 

Low clinical value

Although the researchers said restriction of funding for “low clinical value” treatments may be needed to deliver savings, there is no agreement over which treatments are considered “low value”. 

The Department of Health (DH) said access to services should not be decided on cost, and “suitability for surgery should be judged by clinical experts on the basis of individual need”. 

Significant differences

PCTs which had rationing in place for cataract surgery admitted close to half (48%) the amount of patients than those with no policy, the researchers found. 

When some areas introduced rationing for hernia surgery in 2006/07, 59% fewer patients were operated on in some PCTs, compared to those with no policy. 

Recently the gap has closed between PCTs with policies and those without, but there was still a 15% deficit in 2010/11, the researchers said. 

The researchers compared Hospital Episode Statistics (HES) with PCT policies obtained through a freedom of information (FOI) request. 


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