NHS England 'Evidence Based Interventions' - publication and response from the BOA
This week the NHS England guidance ‘Evidence Based Interventions’ has been published following their earlier consultation exercise, to which the BOA responded in partnership with BESS, BSSH, BASK and BASS.
Seven orthopaedic interventions have been included in the initiative. Two are being decommissioned in full except where an individual funding request is successful (‘category 1’) and five have detailed evidence-based guidance on when they should and should not be offered to patients (‘category 2’). (Both listed below.)
The clinical and evidence sections regarding orthopaedics are now fully supported by the BOA and relevant specialist societies – and we are grateful that NHS England has incorporated orthopaedic input.
However, we have two serious concerns about implementation aspects of the initiative: targets for significantly reducing the numbers of category 2 procedures and ‘prior approval’ processes for these interventions. We have written to NHS England regarding our concerns for patients, in collaboration with BESS and BSSH.
The latest ‘EBI’ document is available as a paper for the NHS England board (which met on Wednesday 28th November 2018).
The seven procedures affected are as follows:
Category 1: Knee arthroscopy for patients with osteoarthritis, injections for non-specific low back pain.
Category 2: Arthroscopic shoulder decompression for subacromial shoulder pain, carpal tunnel syndrome release, Dupuytren’s contracture release in adults, Ganglion excision and trigger finger release in adults.