The NHS in England is proposing to cut funding for 17 procedures it considers unnecessary to save money and eliminate unwarranted clinical variations. One of these procedures is surgical treatments for haemorrhoids. Funding will be approved for this procedure only if certain specific clinical criteria are met. These are that surgical treatment should only be considered for those haemorrhoids that do not respond to non-operative measures including banding or perhaps injection.
Specifically, surgery should be performed according to patient choice and only in cases of persistent grade 1 or 2 haemorrhoids that have not improved with dietary changes, banding or injection and recurrent and symptomatic grade 3 and 4 haemorrhoids and those with a symptomatic external component.
This is based partly on evidence submitted by members of the Association of Coloproctology. Indeed a number of CCGs across England have already implemented this restriction.
As an Association we agree with this evidence-based intervention and support its implementation.