North London NHS to stop hip replacements and tonsillectomies

List of procedures that will no longer be routinely carried out drawn up

Thursday, 14th March 2019 — By Tom Foot

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HIP replacements, cat­aracts, varicose veins and tonsillectomies are among a string of surgical operations that will no longer routinely be carried out on the NHS, under new plans due to be rubber-stamped next month.

Campaigners have warned that the “universal, cradle-to-grave safety net” of the NHS was being “eroded” by cuts that push more patients towards paying for treatment privately.

Last year, the New Journal revealed that some surgical interventions were under threat as part of a review of North Central London NHS Trust’s list of “procedures of limited collective effectiveness” (PoLCE).

NHS chiefs say procedures are no longer effective or have become outdated and that safer, less-invasive alternatives may be available. But Keep Our NHS Public is opposing what it calls a “fraudulent” and “cost-cutting exercise… not simply based on clinical effectiveness, but designed to manage patient demand and reduce the level of expressed need”.

The updated list includes knee and hip replacements, cataract surgery, removal of skin, benign lesions, tonsillectomy, hysterectomy for heavy bleeding, carpal tunnel syndrome release, varicose vein surgery and injections for low back pain.

The new axe list is due to be agreed next month as part of north London’s “sustainability transformation programme” (STP).

The STP is a group of hospital, GP and local authority bosses who are working behind closed doors on a plan to reduce NHS spending in five boroughs, including Cam­­den, by £1billion by 2022.

In many of the cases, the procedures will still be funded by the NHS, but only if patients are meeting a new higher threshold of pain. Campaigners say the new list could be seen as hitting people who suffer from diseases caused by “self-imposed” or “feckless behaviour”. They claim it is being pushed through without consultation, in breach of statutory duties.

Camden Clinical Commissioning Group chairman Dr Neel Gupta said: “We want to have a consistent, evidence-based approach to delivering treatments or procedures. Most important is for every resident to be able to access the treatment they need and for this to be done on the basis of a conversation with the doctor caring for them and for both parties to have clear information to help the discussion and make the right choice.”

He added: “Surgical interventions can result in unintended complications or harm. They should only be offered to patients who really need them and for whom they will work.”

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