Treatment restrictions being imposed as management looks to reduce NHS costs
A COST-CUTTING scheme by Derbyshire's NHS means patients will have to meet stricter criteria before being given a range of treatments, from Caesarean sections to hip and knee replacements.
The scheme outlines a host of restrictions – snoring will not be routinely treated, smokers and over-weight people will be unlikely to get varicose vein operations, and grommets for children with ear infections will only be paid for in serious cases.
Restrictions on treatment will also cover other conditions, including irritable bowel syndrome, tonsillitis and sleep apnoea (breathing difficulties while asleep).
And Caesarean sections will not be routinely offered to women who have hepatitis, are pregnant with twins, have small babies or go into an early labour.
Health bosses say they are only restricting treatments which have very little or no effect on patients' conditions.
And they say the rules simply make clear what national best practice is, with many medics already following these guidelines.
But they admit the new rules will lead to a big enough change to save £1.3m in Derby alone and around £1m across the rest of the county in one year.
The guidance will be put in place across both Derby and the rest of the county.
Dr Rida Elkheir, consultant in public health medicine at NHS Derby City, said: "The NHS has a responsibility to spend public money on services and treatment that benefit as many people as possible, which therefore also means agreeing on treatments which are not to be funded.
"This may be because there is limited evidence that they are effective.
"In the current financial climate, it is clearly more important than ever that we ensure that public money is being spent as wisely as possible."
Dr Richard Richards, assistant director of public health at NHS Derbyshire County, added: "Local GPs and hospital consultants have been involved in deciding upon the list and everyone agrees that these treatments are simply not as effective as others which the NHS needs to be providing for local people."
Dr John Grenville, secretary of Derbyshire Local Medical Committee, believes the cost-cutting measures were inevitable.
He said: "The difficulty is for every pound you spend on a procedure of limited clinical value, benefiting just a few people, you could spend that money on procedures that are known to be of high clinical value to patients.
"It is something that the PCT is bound to look at due to the current financial situation.
"There will be some patients who may miss out on something that might have done them some good but unfortunately it is inevitable."
Catherine Ridgway, who runs Hep C Support Derbyshire, said the news that women with the disease may not get a caesarean section was worrying.
She said: "When women with hepatitis C give birth there is a risk that the baby can contract the disease but a caesarean section can help prevent this from happening. I think the news could worry and upset women."
3 Comments
by Chris, Derby
Sunday, May 16 2010, 12:16PM
“Just watched the Politics Show, East Midlands, and the amazing hypocracy of Councillor Chris Williamson MP already blaming the Conservatives for the cuts. Erm, look back to the day the Tories and Lib Dems were meeting to try to form a coalition, Gordon Brown was still Prime Minoster, and trying to do a deal with the Lib Dems, This is when the NHS announced that they would be making cuts! I suppose the next thing Councillor Willamson, MP will be blaming the Conservatives for is the closure of Celanese!
Let us see how the new coalition Goverment performs and if they deliver on their promise of INCREASING NHS Funding, they have not yet een able to get any of their policies through as they cannot vstart until AFTER the Queen's speech.”
by Pauline McDonagh Hull, Surrey
Tuesday, May 11 2010, 12:34PM
“The news about caesarean delivery here is outrageous and unethical. Why should a woman (even one with a healthy pregnancy) be forced to give birth via a TRIAL of labour? Policy makers in the NHS constantly fail to see the obvious when they attempt cost-cutting. Litigation following obstetric complications, the overwhelming majority of which are an outcome of a planned vaginal delivery and NOT a planned caesarean delivery (see the NHSLA website), costs the NHS more money than any other area of health litigation. Furthermore, injuries to babies and mothers during vaginal delivery (spontaneous and assisted) and emergency caesareans have to be treated, both in the short-term and the long-term (e.g. pelvic organ prolapse), yet these associated treatment costs are never included in cost comparison analysis.
Research has shown that at 39+ gestational weeks, it is safer for a baby to be born via planned caesarean delivery than to undergo a trial of labour ¿ and while this will not be every woman's choice, for those whose choice it IS, they should not be refused on the basis of ill thought out cost-cutting efforts.
This is a disgrace, and one I continue to fight against (see 'cesareandebate.blogspot.com' and 'electivecesarean.com').”
by grandparent, Derby
Tuesday, May 11 2010, 8:44AM
“Instead of cutting services to patients the NHS would be better off it cut out many of the managers. When you have nursing staff reporting to as many as 5 managers is it any wonder there is no money?
To refuse caesarean sections to some patients is ridiculous, the cost of treating babies who have disease passed onto them at birth will be far higher than the initial cost of the section. That does not make economic sense.
What happens if something goes wrong during labour for women having twins or premature birth? The cost of legal action will be a further burden on the NHS.
The one place you do NOT look for cost cuts is in maternity and child birth.
My grandson would have died without a caesarean as he was very premature, in distress, and still the staff were trying to force a normal delivery, using drugs, even though the consultant had said if labour didn't begin within 30 minutes he wanted her in theatre. 4 hours later, with the threat of legal action if they allowed him to die for lack of intervention, they took her to theatre and he was delivered safely. How much was the incubator he began life in, along with the drugs to combat the infection he was born with, due to her waters having broken some 7 days previously? Had they not left her so long maybe he could have been born naturally, with infection raging through his tiny body he was obviously too weak to withstand natural birth.”