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ICB harmonises treatment criteria to tackle CCG inconsistencies

ICB harmonises treatment criteria to tackle CCG inconsistencies

By Jess Hacker
26 September 2022

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Staffordshire and Stoke-on-Trent ICB has agreed to harmonise the eligibility criteria for a number of treatments across six former CCG areas to ensure they are the same across the system’s footprint.

In a board meeting last week (22 September), the ICB agreed to implement changes to four of five policies up for review, following a two-year evaluation involving patients and clinicians.

This would see eligibility criteria for treatment removed entirely for adults with mild hearing loss, with action also expected to be taken across services for:

  • Male and female sterilisation
  • Breast augmentation and reconstruction
  • Removal of excess skin following weight loss.

The policies have been under review since January 2020 to ensure access to services remained the same and to reduce the collective CCGs’ deficit, which stood at £129.3 million at the start of that year, according to a report published at the time.

That same report suggested that increasing efficiencies and introducing a new approach to purchasing services from providers would help reduce that deficit.

According to the Board’s latest policy proposal, breast augmentation and reconstruction will be routinely funded following mastectomies carried out due to suspected or proven cancer or following double mastectomies for cancer prevention in high-risk cases.

This will improve on the policy for the five CCG areas that only offered post-mastectomy reconstruction in the affected breast.

However, this will see a reduced offer in North Staffordshire and Stoke-on-Trent who currently offer reconstruction due to burns, and again in Stoke-on-Trent which offers augmentation for developmental failure and significant asymmetry.

Female sterilisation will be routinely funded for contraception when a person is unable to tolerate other contraceptives, or where there is absolute clinical contraindication to pregnancy. Currently there is no criteria in place.

The ICB also said it will no longer commission abdominoplasty/apronectomy or body contouring, which will reduce services in all six areas.

Dr Paul Edmondson-Jones, the ICB’s chief medical officer, this week said: ‘This has been a long journey, partially because of Covid, but also because we wanted to make sure we did everything correctly and followed the clinical evidence.

‘We shall now be talking to our local authority Health Overview and Scrutiny Committees to explain how we intend to implement these new policies.’

Assisted conception was initially part of this review but was dropped following new guidance from the national Women’s Health Strategy, published in July 2022 which.

The ICB intends to develop an interim policy for assisted conception until further national guidance is published.

Former CCG areas that are covered by the Staffordshire and Stoke-on-Trent ICB are: Cannock Chase; East Staffordshire; North Staffordshire; South East Staffordshire and Seisdon Peninsula; Stafford and Surrounds; Stoke-on-Trent CCG.

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