NHS England to consult on plans to cut back 100,000 ‘unnecessary procedures’

Breast reductions and operations to stop people snoring are among a list of treatments which could be cut back in plans to prevent more than 100,000 “unnecessary procedures” taking place annually.

NHS England said an estimated £200 million could be saved every year by tightening criteria for treatments where “the risks… outweigh the benefits”.

It said the proposals will ensure procedures, such as those for carpal tunnel, haemorrhoids and varicose veins, will only take place where there is good reason to do so.

Alternative treatments such as injections, changes of diet or physiotherapy will be effective in the majority of cases, NHS England said.

National medical director Professor Stephen Powis (pictured) said: “If we want the very best clinical care for our patients, we need to stop putting them through treatments where risks and harms outweigh the benefits.

“By reducing unnecessary or risky procedures for some patients we can get better outcomes while reducing waste and targeting resource to where it is most needed. “

Speaking to the Times, he added this would be the “first stage” in looking at situations where surgery is better avoided.

He told the paper: “We shouldn’t, at best, inconvenience or disappoint patients by offering treatments that are not effective and, at worst, harming patients.”

NHS England’s board of directors will meet next week to discuss the plans which will then be put out to consultation.

Other procedures on the list of 17 include grommets for glue ear and tonsil removal, with the plans drawn up in consultation with the National Institute for Health and Care Excellence (Nice).

Four of them will be offered only when a patient makes a specific request, with the other 13 being offered only when specific criteria are met.

Professor Gillian Leng, deputy chief executive at Nice, said: “It has become commonplace for us to associate action with treatment.

“However, sometimes doing nothing, or doing less, really is the best approach.

“Treatments and procedures that carry a high risk or are associated with serious side effects should only be offered when there is compelling evidence that the benefits are worthwhile.”

Dr Graham Jackson, co-chair of NHS Clinical Commissioners, said: “It is important that we have an honest conversation with the public, patients and clinicians about what can be expected from the NHS within the constrained funds it has available.”

The plans would see the commissioning of 17 procedures reduced or stopped with other, less invasive, treatments being used instead to save up to £200 million.

Four procedures will only be offered upon a request from the patient. These are:

• Snoring surgery
• Dilation and curettage for heavy menstrual bleeding
• Knee arthroscopies for osteoarthritis
• Injections for non-specific back pain.

A further 13 treatments will only be offered when certain conditions are met. These are:

• Breast reduction
• Removal of benign skin lesions
• Grommets for glue ear
• Tonsillectomy
• Haemorrhoid surgery
• Hysterectomy for heavy menstrual bleeding
• Removal of lesions on eyelids
• Removal of bone spurs for shoulder pain
• Carpal tunnel syndrome release
• Dupuytren’s contracture release
• Excision of small, non cancerous lumps on the wrist called ganglia
• Trigger finger release
• Varicose vein surgery

_{Copyright (c) Press Association Ltd. 2018, All Rights Reserved. Picture (c) Youtube.}