There is no rationing.. ? !!

The Telegraph 267th Jan 2017:

The Telegraph September 2016:
The Telegraph 9th Aug 2016:
The Express 12 days ago:
The Daily Mail:
The Standard 6 days ago:
The Times today:

Patients will be refused hip and knee replacements unless they are in so much pain that they cannot sleep or go about their daily lives, under the latest NHS rationing plans.

Health chiefs in the West Midlands are using a scoring system designed to assess patients’ illness to reduce hip operations by 12 per cent and knee replacements by 19 per cent. The move is intended to save £2.1 million a year.

Very obese patients would be refused surgery unless they could show that they had lost 10 per cent of their body weight or were in danger of losing their independence, the Health Service Journal revealed.

The Royal College of Surgeons (RCS) said yesterday that the “alarming” cost-cutting plans would inflict needless suffering on patients. It said that thousands of people were falling victim to arbitrary denial of treatment.

About 160,000 hip and knee replacements a year are carried out by the NHS in England and Wales and the figure is rising by about 8 per cent annually as the population ages. The prostheses replace joints worn by age or damaged by conditions such as arthritis.

Most patients are elderly but the number of replacements provided in people aged under 60 has increased by 76 per cent to 18,000 during the past decade. Better surgical results and more durable implants mean that joints can be replaced in younger people without the need for operations to be redone after 15 years. Doctors also say that younger patients are less willing to wait for surgery than in the past.

Stephen Cannon, vice-president of the RCS, said that the decision to restrict access to NHS care, based on arbitrary pain and disability thresholds, was alarming.

“It is another example of how the huge financial strains the NHS is under are directly affecting patients. It is right to look at alternatives to surgery but this decision should be based on surgical assessment, not financial pressures.”

He added that the savings estimate “overlooks the longer-term impact on patients of delayed treatment, prolonged pain and potentially higher costs of treatment. For example, patients affected by these changes may require additional pain relief medication and may still require surgery further down the line.”

Redditch and Bromsgrove, South Worcestershire, and Wyre Forest, the three local health groups implementing the plans, hope to avoid 350 operations a year. Paul Green, from Saga, said: “To suggest that it is acceptable for people to have to wait until they are unable to sleep before they are eligible for an operation is an outrage. How would these people feel if that was their mother or father or grandparent?”

Three years ago the RCS found that 44 per cent of local clinical commissioning groups required patients to be in various degrees of pain before surgery, against advice from the National Institute for Health and Care Excellence.

NHS Redditch and Bromsgrove Clinical Commissioning Group said: “The Oxford scoring system is a guidance for clinicians and they recognise that many patients will benefit from physiotherapy and weight loss before considering surgery. If a patient feels that they require this surgery but do not meet these criteria, there is a clear appeals system via individual funding requests.”

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This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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