Low Priority Procedures
All outpatient and inpatient 'episodes' (including all NHS operations) in NHS Hospitals are at present 'commissioned' and paid for by the local Primary Care Trust (PCT). Unfortunately my local PCT (in common with many if not all around the country) is over budget and is having to make considerable year on year savings. The provision of all services (including all operations) is under constant strict review and many operations are now not funded on the NHS, and are termed 'Low Priority Procedures' or LPP.
For a definitive list of LPP in Kent and Medway, see http://bit.ly/dbgaDi
In Ear, Nose and Throat Surgery, the spotlight has fallen particularly on operations such as tonsillectomy, grommet insertion for glue ear, operations such as septoplasty and septorhinoplasty to relieve a blocked nose and procedures to help snoring. Our local PCT has begun to refuse to reimburse the Hospital Trust I work at for operations that they deem 'Low Priority', despite the decision by the Consultant Surgeon involved to operate on the basis of clinical need - crazy !
This fact was highlighted once again in Health section of The Daily Telegraph under the headline 'Patients denied treatment as NHS makes cutbacks' (see http://tgr.ph/hUskhf ) and The Independent has reported on this again more recently - see http://ind.pn/nguj61 .
Many operations in Ear, Nose and Throat (ENT) Surgery that I perform are for non life threatening problems, but as we ENT surgeons know (and patients who have had these operations definitely know) they are usually quality of life enhancing and often life changing.
Unfortunately, in the current poor financial climate the fact that central Government has promised to not reduce central funding doesn't mean that heavy year on year 'efficiency savings' are not being being enforced in our Hospital Trust. There is only a certain amount of slack in a service that is already working flat out.
These savings are also having to be made with the news that the amount of money (or 'tariff') Hospitals are being paid for all interventions is due to fall by at least 1.5% next year. Obviously, reducing the amount of work done (and paid for) by your local Hospital will save some money....
The maths is not difficult to work out, and regrettably it means that the list of elective (i.e non-emergency) interventions and operations in the NHS is likely to fall further in the future and the days of a universal NHS ENT service are in all probability over for good.
The argument I hear is that the patients who used to be seen at the Hospital can now be dealt with by GPs with Special Interest (GPwSI) or Specialist Nurses. I'm afraid to say that while GPs are very good Medical Generalists and occasionally very good at certain Medical and Surgical Specialities, they will not have the training or knowledge to match a Hospital Specialist in their field, any more than I would be able to do their job !! I know who I would want to see if I had a specific medical or surgical issue, and that is a specialist in that particular field.....
All the more reason, if you afford it, to consider Private Medical Insurance for you and your family.
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