Guidance has been issued from NHS England about surgical treatments that will no longer be offered or only funded when specific criteria are met.

NHS England (NHSE) has published statutory commissioning guidance that sets out clinical criteria for 17 interventions which will be implemented from January 2019.

The aim of the statutory guidance is to reduce the number of inappropriate interventions provided on the NHS. The primary goals of the Evidence-Based Interventions programme are to avoid needless harm to patients and free-up scarce professional time for performing other interventions - including creating headroom for proven innovations. The time saved will be reinvested in patient care.

The ambition is to improve clinical outcomes for the population by ensuring that patients only receive interventions for which there is an established, high-quality evidence base.

NHSE has produced guidance on the following four interventions that should no longer be routinely commissioned or offered because they do not work or have been superseded by a safer alternative. However, we recognise that there will always need to be a process to consider the atypical or uncommon patient, these will be considered by the Individual Funding Request Panel.

The following four interventions will only be offered to patients if prior-approval is obtained via this route, please click on the links below to see the guidance:

• Snoring Surgery (in the absence of Obstructive Sleep Apnoea)
• Dilatation and curettage for heavy menstrual bleeding in women
• Knee arthroscopy for patients with osteoarthritis
• Injections for nonspecific low back pain without sciatica

A further thirteen interventions will only be offered when specific clinical criteria are met (as they have only been shown to be appropriate in certain circumstances). Please click on the links below to see the guidance:

• Breast reduction
• Removal of benign skin lesions
• Grommets for Glue Ear in Children
• Tonsillectomy for recurrent tonsillitis
• Haemorrhoid surgery
• Hysterectomy for heavy menstrual bleeding
• Chalazia removal
• Arthroscopic shoulder decompression for subacromial shoulder pain
• Carpal tunnel syndrome release
• Dupuytren’s contracture release
• Ganglion excision
• Trigger finger release
• Varicose vein surgery