An Essex father has become the latest casualty of the funding crisis in the NHS, which is leading to rationing of treatments, according to a report in January 2019 in the Essex Standard.
Matthew Pascoe has been diagnosed with a rare condition, known as gastroparesis, in which his stomach can not empty of food. As a result, Matthew suffers vomiting and can not successfully digest his food. According to consultants, his only option is an operation to fit an electrical device to stimulate his stomach to empty.
Despite the operation being Matthew’s only hope of leading anywhere near a normal life, the NHS will not fund it. The operation will cost £17,000 and Matthew is now hoping a gofundme page will raise enough money.
Matthew is not alone in finding the NHS refusing to fund treatment. In November 2018, an investigation by The BMJ and diabetes campaigner Nick Cahm found that despite being available on the NHS, a new tiny glucose monitor that is designed to improve quality of life and save money for type 1 diabetics is not being prescribed by many CCGs.
The investigation found that 25 of 195 CCGs in England have not yet issued a single prescription for the device; other CCGs had offered the device to almost 25% of people with type 1 diabetes.
Rationing of surgery is becoming more common. In July 2018, an investigation by the Royal College of Surgeons and the British Hernia Society found that the rationing of surgery for hernia problems is widespread. Almost six out of 10 CCGs are denying quick access to the procedure inguinal hernia surgery. If patients don’t receive this surgery quick enough they can be left in pain and at the risk of needing emergency surgery or even of death. The investigation found that the number of NHS organisation that are restricting access as a way to cut costs has doubled since 2014.
In the same month, the British Medical Journal reported that there has been a sharp increase in the number of patients blocked from receiving hip or knee operations by panels set up by CCGs to assess funding requests.
These panels were set up to deal with exceptional funding requests – operations not routinely done by the NHS – however now GPs are having to apply to the panels more and more frequently for operations, such as hip and knee replacements, which used to be routinely funded on the NHS.
Between 2016-17 and 2017-18 there was a 45% increase in the number of patients rejected after their GPs recommended them for surgery in this way.
The charity Breast Cancer Now reported in June 2018 that nearly a quarter of local NHS commissioning groups had introduced policies to restrict reconstruction services for non-clinical reasons. The policies have included limiting the number of surgeries women were allowed, putting a time-frame on when they could have the surgery, and also led to some women being denied operations to ensure both breasts were symmetrical.
Freedom of information requests to all 208 Clinical Commissioning Groups (CCGs) in England showed 47 (22.6%) had established restrictive policies, while a further nine (4.3%) had draft policies or informal restrictions in place. Baroness Delyth Morgan, chief executive of the charity, said it was “totally unacceptable” that any patient was being denied reconstructive surgery – or being rushed into potentially life-changing decisions.
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