Dr. David Porteous, a General Practitioner in Bristol, England recently reported to the Bristol Cable, a community-run newspaper, that he does not agree with the extensive list of treatments being restricted by the Clinical Commissioning Group (CCG).
Dr. Porteous explained that his patients are shocked when they learn that they will not receive the treatment that they urgently need. He said that they take their anger and frustration out on “the messenger”.
He has been practicing medicine for over twenty years. Dr. Porteous said he agrees that ineffective treatments or cosmetic procedures should be restricted. However, he does not see any merit in denying treatment that would improve a patient’s quality of life.
The doctor described the effect of the ever-increasing list of restrictions that force him to deliver bad news to his patients. The patients come to him in pain. Some have difficulty breathing or walking. They are truly suffering. Dr. Porteous explains that he is not in agreement with these “cuts” and only wants to be able to administer to his patients.
One example that he used describes a patient with nasal impairment caused by polyps. The CCS criteria read ‘significant impairment of functioning.’
Dr. Porteous’ patient was unable to breathe through his nose, could not sleep, had difficulty eating but according to the CCS, it did not fit its criteria. The patient could not have surgery.
A National Problem
According to results of an investigation by a British Medical Journal, 1,700 people in England applied for hip and knee surgery between 2017 and 2018. This was a forty-five percent increase in applications in a one year period.
The Royal College of Surgeons reports that due to the CCG’s restrictions, in 2018 alone thousands of patients in need of hernia operations were denied access.
Another group voicing concern is the British Orthopaedic Association (BOA). It is focusing on the CCS’s policy involving surgery for the foot and ankle. In order to qualify for surgery, the CCS requires that the patient is experiencing ‘severe pain’ that causes ‘significant functional impairment.’
The BOA points out that patients may be affected by their disease without actually fitting into the CCS’s stark description. Their concern is that the patient will be denied surgery or effective treatment.
Add ENT UK to the group of people questioning the CCS restrictions. A spokesman for the ear, nose and throat specialists explained that the members of the association and its affiliates believe patients should not be denied access to treatment. He emphasized that it is “outrageous” to deny patients treatment or diagnosis.
A Case In Point
Although it reached a point that “Tim” was barely able to walk, he was still denied treatment due to CCS restrictions. Tim’s feet were deformed yet he would lose his job if he took a leave of absence. He could not get treatment and had nowhere to turn.
Power of the Panel
As the number of restriction grows, so does the number of specialists who are critical of its policies. The CCS list includes hip, knee and hernia surgery.
As these situations continue, it appears that power is being shifted from the general practitioners to the panel. Some of the GPs interviewed by the Cable have said that their patients are not only burdened by their illness but also the disappointment of being rejected with no hope of recovery.
A local group called Protect Our NHS was formed to bring accountability to the CCG. It uses the slogan ‘Stolen Treatments’. It is partly a response to the NHS England’s new restrictions covering seventeen procedures it deems to be “ineffective or risky”. Its directive must be followed by the CCG.
A Word From CCG
A spokesperson for the CCG claimed that it is addressing its responsibility and meeting the needs of its population in using NHS funds to ensure that patients are getting treatment when there is definite evidence that “the benefits outweigh the risks.”