Minor surgery put on hold to save NHS cash

Published on Sunday 18 December 2011 00:00

HOSPITALS are cutting back on minor surgical procedures to save money as the health service faces up to the toughest financial climate in years.

Information received by Scotland on Sunday reveals that at least three health boards are looking at limiting access to varicose vein surgery, cosmetic procedures and other operations to make the best use of limited funds, sparking fears of a postcode lottery of access to some treatments,

It comes on top of action already taken to slash staff numbers across the NHS, which has seen thousands of jobs go in the past two years.

Scotland on Sunday used Freedom of Information legislation to ask health boards if they had had to reduce any services over the last year, change eligibility criteria for some procedures or have future plans to alter levels of provision.

Most of those that responded claimed they had not had to make any cuts to services – despite figures showing that more than 3,600 NHS staff posts have been lost across Scotland in the past year.

But other boards revealed that they had been forced to look at minor procedures, including operations regarded as having “low health gain”, such as tonsillectomies, grommets and varicose vein surgery.

In its response, NHS Borders said: “The board is implementing a process to restrict access to a range of procedures which have been assessed as having limited clinical effectiveness.” The board declined to name all the procedures affected.

But Calum Campbell, NHS Borders chief executive, said: “An example, is the Specialist Weight Management Team we have put in place to provide increased support to patients to lose weight. This is an alternative to bariatric surgery which carries significant risks and side-effects. Bariatric surgery will still be available to those patients in greatest need.”

NHS Ayrshire and Arran refused to go into detail on the procedures that would be affected, but also indicated cutbacks to cosmetic procedures.

The board said: “The criteria for major procedures are based on clinical need not budgetary. However, some minor changes may occur due to financial constraints (this may be only temporary), for example, minor surgery enhanced service specification has been amended to exclude purely cosmetic procedures, such as the removal of skin tags.”

Earlier this year, NHS Greater Glasgow and Clyde revealed that it was reviewing some procedures as it attempted to make savings of £55 million.

The board said: “Working with our clinicians to develop guidelines to consider reducing low health gain procedures such as tonsillectomies, grommets, varicose veins, dilation and curettage [a gynaecological procedure] and minor lumps surgery remains a priority for us to ensure that we deliver high quality and clinically effective services.”

Norman Provan, associate director at the Royal College of Nursing in Scotland, said the way the cuts were being made meant there would be inequalities in provision.

“You risk the postcode lottery of it being dependent on what part of the country you live in and what services are being provided to people,” he said.

Brian Keighley, chairman of the British Medical Association Scotland, said the next year would be a “crunch year” and there was also a danger that the cuts could impact on the ability of the NHS to meet its 18-week referral to treatment target – due to be met by the end of the month. “The Scottish Government has to decide what it can and can’t afford and be honest with the public that all things are not as affordable as they used to be,” he said.

Health Secretary Nicola Sturgeon commented: “We are committed to ensuring that our NHS delivers top quality care, to every patient, every time.”

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