Commissioners defend policies on surgery referrals amid accusations of rationing

Health commissioners have defended their policies on referring patients for surgery, after an investigation by the Royal College of Surgeons claimed that evidence based guidance was being ignored and patient care compromised.

The college’s report—Is Access to Surgery a Postcode Lottery?1—analysed commissioning policies obtained under the Freedom of Information Act in April from 52 clinical commissioning groups (CCGs), 27% of the 211 CCGs in England. It investigated policies on four common surgical procedures—tonsillectomy, hip replacement, inguinal hernia repair, and otitis media with effusion—and compared them with evidence based guidance published by the Royal College of Surgeons, surgical specialty associations, and the National Institute for Health and Care Excellence (NICE).

The investigation found that 73% of CCGs reviewed (38 of 52) did not follow NICE or clinical guidance on referral for hip replacements or had no policy in place …