Health chiefs defend cataract surgery rationing

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Health chiefs have defended their policy of rationing cataract surgery to people in Horsham, Crawley and Mid Sussex.

People in the district are being denied the life-changing procedure in defiance of guidelines from the Department of Health - unless their eyesight is deemed sufficiently poor.

The Horsham, Mid Sussex and Crawley Clinical Commissioning Groups - which are responsible for paying for local health services - say they do not ‘routinely fund’ cataract operations. Only people who score worst in visual tests are considered for surgery.

But the National Institue for Health and Care Excellence - which aims to improve outcomes for people using the NHS - has urged an end to the postcode lottery. It told health authorities last October to stop limiting cataract surgery based on visual test scores.

And the Royal National Institue of Blind People says: “NHS ‘efficiency savings’ achieved by cutting cataract operations are a false economy. Denying treatment leaves patients at risk of social isolation and fall-related injuries which are often more costly to treat in the long-term.”

NICE states: “Any arbitrary use of visual thresholds for referral or surgery which restricts access, creates inequitable care and is not justified.”

But the Horsham, Crawley and Mid Sussex Clinical Commissioning Groups says that NICE’s directives are merely guidelines and are not compulsory.

A spokesman said: “The clinical policy in place does consider other factors affecting a patient’s quality of life, as well as visual acuity.

“NICE guidelines are always considered in the commissioning of services but they are guidelines, not mandatory, and where there is no impact on patient safety, not all guidelines can be fully adopted.

“The CCGs have a duty to ensure we use the limited resources we have available in the most effective way for our patients, particularly when commissioning procedures that have high volumes of people needing treatment.

“This can only be done by having clear policies in place that allow us to prioritise patients who have the greatest clinical need.”

The denial of surgery to cataract patients locally is just one of a range of NHS treatments now being rationed in Horsham, Crawley and Mid Sussex.

Patients are being told that ‘minor’ operations - from investigative joint surgery, haemorrhoid removal, skin lesion treatment and treatment for varicose veins, along with a string of treatments for other conditions - are no longer being routinely funded by the NHS.

The commmissioning groups - which have been placed in ‘special measures’ by NHS England after being rated ‘inadequate’ because of massive overspend in their budgets - say they have “designated a number of procedures as low priority for NHS funding.”

They say there is no ‘blanket ban’ and that individual funding requests can be made to the CCGs by patients’ GPs.