NHS England Board paper 4 July 2018
- NHS England will consult on the Evidence-Based Interventions programme, developed and jointly led by NHS England, NICE, NHS Improvement, the Academy of Medical Royal Colleges, and NHS Clinical Commissioners.
- The focus of the programme is on surgical interventions commissioned by CCGs, where there was high variability in the application of clinical guidelines.
- Priority was given to changes which could test the approach and implement relatively quickly on a large scale.
- The consultation proposes that four interventions (Category 1) that should no longer be routinely commissioned by CCGs unless accompanied by a successful Individual Funding Request (IFR) and 13 interventions (Category 2) that should only be commissioned by CCGs or performed when specific evidence based clinical criteria are met. It is proposed that Category 1 interventions will be set at zero tariff in National Tariff without a successful IFR.
- Category 1
- Snoring Surgery (in the absence of OSA)
- Dilatation and curettage (D&C) for heavy menstrual bleeding in women
- Knee arthroscopy for patients with osteoarthritis
- Injections for nonspecific low back pain without sciatica
- Category 2
- Breast reduction
- Removal of benign skin lesions
- Grommets for Glue Ear in Children
- Tonsillectomy for Recurrent Tonsillitis
- Haemorrhoid surgery
- Hysterectomy for heavy menstrual bleeding
- Chalazia removal
- Arthroscopic shoulder decompression for subacromial shoulder pain.
- Carpal tunnel syndrome release
- Dupuytren’s contracture release
- Ganglion excision
- Trigger finger release
- Varicose vein surgery
- Proposals also suggest that changes in the NHS Standard Contract will require commissioners and providers to comply and enable commissioners to withhold payment.
- The consultation paper includes evidence to support the proposals, and STP level and CCG level activity data for the 17 interventions.
- Phase 2 will be launched in early 2019 and will consult on further interventions and will also include specialised services which are commissioned by NHS England
- See the consultation document (paper 4b) for details.
- Public consultation 4 July – 28 September 2018.
- See also the Choose Wisely campaign
