Commissioning Policy Individual Funding Request

Transcription

1 Commissioning Policy Funding Request Congenital Ear Deformity Correction Surgery (including Pinnaplasty) Funding Request Policy Date Adopted: 13 October 2017 Version: Funding Request Team - A partnership between Bristol, North Somerset and South Gloucestershire Clinical Commissioning Groups

2 Document Control Title of document Congenital Ear Deformity Correction Surgery (including Pinnaplasty) Authors job title(s) IFR Manager Document version v Supersedes v Clinical approval June 2017 Discussion and Approval by 14 June 2017 Clinical Policy Review Group (CPRG) Discussion and Approval by CCG 05 September 2017 Governing Body Date of Adoption 13 October 2017 Publication/issue date September 2017 Review date September 2020 Application Form Version Control Current IFR Form Equality and Impact Assessment TBC Version: Page 2

3 THIS TREATMENT IS NOT ROUTINELY COMMISSIONED FOR ANY PATIENTS AND INDIVIDUAL FUNDING PANEL APPROVAL MUST BE SOUGHT PRIOR TO REFERRAL THIS POLICY RELATES TO ALL PATIENTS CONGENITAL EAR DEFORMITY CORRECTION SURGERY (INCLUDING PINNAPLASTY) Policy Statement and Date of Adoption: 13 October 2017 General Principles Funding approval will only be given in line with these general principles. Where patients are unable to meet these principles in addition to the specific treatment criteria set out in this policy, funding approval will not be given. 1. Funding approval must be secured by primary care prior to referring patients for assessment. Referring patients to secondary care without funding approval having been secured not only incurs significant costs in out-patient appointments for patients that may not qualify for surgery, but inappropriately raises the patient s expectation of treatment. 2. On limited occasions, the CCG may approve funding for an assessment only in order to confirm or obtain evidence demonstrating whether a patient meets the criteria for funding. In such cases, patients should be made aware that the assessment does not mean that they will be provided with surgery and surgery will only be provided where it can be demonstrated that the patients meets the criteria to access treatment in this policy. 3. Where funding approval is given by the Funding Panel, it will be available for a specified period of time, normally one year. 4. Funding approval will only be given where there is evidence that the treatment requested is effective and the patient has the potential to benefit from the proposed treatment. Where it is demonstrated that patients have previously been provided with the treatment with limited or diminishing benefit, funding approval is unlikely to be agreed. 5. Patients with an elevated BMI of 30 or more are likely to receive fewer benefits from surgery and should be encouraged to lose weight further prior to seeking surgery. In addition, the risks of surgery are significantly increased. (Thelwall, 2015) 6. Patients who are smokers should be referred to smoking cessation services in order to reduce the risk of surgery and improve healing. (Loof S., 2014) Version: Page 3

4 Background Pinnaplasty Pinnaplasty surgery is a cosmetic procedure normally performed on a child in order to correct the absence of a Helix formation in one or both ears. Cryptotia Cryptotia means buried ear. This is a relatively rare deformation in which the groove behind the ear is not fully formed. Microtia / Anotia Microtia is a congenital deformity where the pinna is underdeveloped. A completely undeveloped pinna is referred to as anotia. Both Cryptotia and Microta can be cosmetically displeasing and can on occasion lead to issues with wearing spectacles. Policy Criteria to Access Treatment INDIVIDUAL FUNDING PANEL APPROVAL REQUIRED Congenital ear deformity correction surgery is not routinely commissioned. Patients who are not eligible for treatment under this policy may be considered on an individual basis where their GP or consultant believes exceptional circumstances exist that warrant deviation from the rule of this policy. cases will be reviewed at the CCG s Funding Request Panel upon receipt of a completed application form from the patient s GP, consultant or clinician. Applications cannot be considered from patients personally. If you would like further copies of this policy or need it in another format, such as Braille or another language, please contact the Patient Advice and Liaison Service on or Version: Page 4

5 Connected Policies N/A This policy has been developed with the aid of the following references: BIBLIOGRAPHY Loof S., D. B. (2014). Perioperative complications in smokers and the impact of smoking cessation interventions [Dutch]. Tijdschrift voor Geneeskunde, vol./is. 70/4( Thelwall, S. P. (2015). Impact of obesity on the risk of wound infection following surgery: results from a nationwide prospective multicentre cohort study in England. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases,, vol. 21, no. 11, p e1. Approved by (committee): Clinical Policy Review Group Date Adopted: 13/10/2017 Version: Produced by (Title) Commissioning Manager Funding EIA Completion Date: TBC Undertaken by (Title): Review Date: Earliest of either NICE publication or three years from approval. CATEGORY VERSION CATEGORY VERSION CATEGORY VERSION Bristol North South Funding Request Somerset Funding Gloucestershire Funding Request Request Version: Page 5