NHS England intervenes on rationing in surgery

Responding to an email published in HSJ from NHS England warning CCGs over ‘arbitrary rationing’,  Miss Clare Marx, President of the Royal College of Surgeons, said:

“It is extremely welcome news that NHS England has now intervened to discourage clinically unacceptable rationing of surgery in the NHS. There have been growing examples of commissioning groups (CCGs) ignoring NICE guidance and imposing arbitrary pain, weight, or smoking thresholds to defer or prevent patients from receiving timely surgery as a way of saving money.

“In particular, NHS England has reminded CCGs that patient-specific factors such as smoking or obesity should not be barriers to referral for hip and knee replacement surgery. Patients should always be encouraged to quit smoking and lose weight for their overall health. However making it a condition of their treatment is unjust. NHS England has also reiterated that there is strong evidence hip and knee replacements are extremely cost-effective interventions when warranted by clinical need.

“The guidance in this letter is a very welcome start. However, it only criticises the rationing of hip and knee surgery. Patients are left wondering about the validity of restrictions to other types of surgery and NHS treatment.

“Given this very clear intervention from NHS England we strongly encourage CCGs to reverse any existing discriminatory policies.”

Notes to editors

The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

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