i find this to be a sign of things to come throughout the country. the NHS blogdoc posts copies of letters (small print but not impossible to get the general content) sent to the hospital chief executives and GPs of Yorkshire stating that due to dire financial circumstances restrictions will be placed on the following procedures.
looks pretty grim for people with low back pain in Yorkshire....
From the 1st January the PCT has introduced Prior Approval system for access to a range of common elective treatments. Decisions are based on patients needs and evidence of clinical effectiveness. Access to these services will now only be available through Prior Approval and only in exceptional circumstances. The PCT has defined exceptional circumstances as those in which:-
* Denying access to the treatment or diagnostics would place the patient’s safety and/or health at significant risk
* Denying access to the treatment or diagnostics would significantly alter the longer term outcome of any future procedure
* Denying access to the treatment or diagnostics would significantly impair the patient’s ability to maintain their current occupation
http://nhsblogdoc.blogspot.com/The PCT has reviewed the evidence base and the clinical benefits of a range of common procedures and treatments and proposes to implement Prior Approval as follows:-
Group 1 – Services suspended indefinitely
* Lumbar spine X-rays for lower back pain except by prior agreement with local Radiologist
* Facet joint injections for chronic lower back pain
* Anal skin tags
* Treatment/removal of all non malignant skin lesions
Group 2 – Services suspended for 3 Months
The PCT proposes to temporarily suspend access to these services in secondary/tertiary care providers for 3 months whilst further work is carried out to determine future commissioning arrangements and care pathways.
* Varicose veins
* Epidurals for chronic lower back pain
* Wisdom teeth extraction
* Joint injections – should continue in primary care, referral into secondary care will require prior approval.
* Palmar fasciectomy for Dupytren’s disease
* Carpal tunnel procedures – injections should continue in primary care, referral into secondary care for carpel tunnel will require prior approval
* Bunion surgery
* Ganglions – aspiration should continue in primary care, referral into secondary care will require prior approval.
* Trigger Finger – injections should continue in primary care, referral into secondary care will require prior approval.
* Vasectomy
* Female Sterilisation
* Circumcision
* Penile Implant surgery
* Therapeutic Arthroscopy
* Grommets
* IVF
* Tonsillectomy
* Hysterectomy for menorrhagia
Group 3 – Diagnostic Procedures Suspended for 3 Months
The following diagnostic procedures are being temporarily suspended for 3 months whilst the PCT carries out further work to determine future commissioning arrangements and care pathways:
* Diagnostic Arthroscopy
* Dilatation and curettage
Group 4 – Diagnostic Imaging Services Suspended for 3 Months
The PCT is reviewing the capacity of Diagnostic Imaging services and will suspend for 3 months GP direct access to the following services. These will continue to be available via Prior Approval.
* Direct access MRI
* Direct Access CT
* Direct Access Dexa
