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Views And Reviews Acute Perspective

David Oliver: Are we seeing value based rationing clearly?

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l1734 (Published 17 April 2019) Cite this as: BMJ 2019;365:l1734
  1. David Oliver, consultant in geriatrics and acute general medicine
  1. Berkshire
  1. davidoliver372{at}googlemail.com
    Follow David on Twitter: @mancunianmedic

Leaders of public healthcare systems must make tricky decisions about prioritising resources, and they need public and professional engagement for this difficult role. Even a deluge of extra funding, after a relative drought of flat increases, wouldn’t magically wash away this need, but a recent report by the Medical Technology Group left me wondering whether England’s NHS is getting it right.

The report examined rationing of elective cataract surgery, using data from freedom of information requests sent to clinical commissioning groups (CCGs) in England. In total, 104 groups included elective cataract surgery on their list of “procedures of limited clinical value.”1 Of these, 76 used a “visual acuity threshold” before patients could be considered for …

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