Nine in 10 primary care trusts are rationing access to four procedures

BMJ 2012; 344 doi: (Published 19 June 2012) Cite this as: BMJ 2012;344:e4258
  1. Nigel Hawkes
  1. 1London

Nine out of 10 primary care trusts now have policies in place to limit access for patients to at least one of four procedures deemed “non-urgent” or of “limited/low clinical value”—joint replacement, cataract surgery, tonsillectomy, and bariatric surgery.

Freedom of information requests by GP Magazine to all 151 trusts in England elicited 101 responses.1 Only eight of those responding said that they had no thresholds or limits on referrals: Airedale, Birmingham East and North, Bradford, Devon, Heart of Birmingham, Isle of Wight, Oldham, and Solihull. The rest had at least one limit in place, and 27 limited all four procedures.

Tonsillectomies were hardest hit, with 89% of trusts having limits in place. Two thirds limited cataract surgery …

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