In February 2019 the CCG received 64 postcards from members of the public regarding access to treatments. The CCG received a further 40 postcards signed by members of the public on the 14 August 2019. These postcards have the same statement, below, as those received in February.
Dear Julia Ross, I strongly object to the Bristol, North Somerset and South Gloucestershire CCG restricting access to 104 treatments as listed on your website. I demand that I - and my GP – have full access to NHS specialist assessment and care. The restrictions on cost effective treatments such as hip replacements and hernia repair mean that people are forced to live in pain, left to suffer worsening health and disability, and rendered at risk of serious medical consequences. There has been no public consultation about these changes. Please provide me with an explanation, backed by evidence, to support your unsafe and deeply worrying commissioning policies.
The CCG's response is below:
Bristol, North Somerset and South Gloucestershire CCG has a duty to ensure the very best use of NHS funds when meeting people’s healthcare needs. We always seek to ensure that our decisions are based on the best clinical evidence and through engagement with the people we serve. The demand for services is greater than the resources available, and therefore we have to prioritise carefully. Our approach is to prioritise the commissioning of the most clinically effective treatments, operations or drugs.
Our approach is to prioritise commissioning treatments, operations or drugs that are most effective in meeting the health needs of the population. All operations carry significant risks and where symptoms are mild or moderate it is likely that the risks outweigh the benefits. Not all conditions progress and when symptoms can be managed conservatively, that is the safest option. For example, the National Institute for Health and Care Excellence recommend hip surgery only for people with end stage arthritis in whom non-surgical management has failed. Where treatments, drugs or operations provide a limited benefit, or are unusual or uncommon, they are not routinely commissioned and appear on the CCG’s Interventions Not Normally Funded (INNF) list. All commissioning policies are regularly reviewed in line with NHS England guidelines and NICE Technology Appraisal Guidance. The CCG is currently reviewing all commissioning policies in order to pay due regard to NHS England’s recent guidance regarding evidence based interventions.