NHS England (NHSE) has issued statutory commissioning guidance to CCGs to introduce and implement commissioning policies for 17 selected interventions.

The aim of the statutory guidance is to reduce the number of inappropriate interventions provided on the NHS and to avoid needless harm to patients. This will free-up scarce professional time for performing other interventions, which 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.

The following four interventions will only be offered to patients when an individual funding request (IFR) has been approved. 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. Please click on the links below to see the guidance:

• Breast reduction - *soon to be updated*
• 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 (from 31 March 2019)
• Varicose vein surgery