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Evidence-based interventions programme consults on tight new guidance for 17 treatments

What treatments are likely to be next for EBIP scrutiny?


NHS England officials have presented board members with proposals to strictly limit the provision of 17 interventions regarded as being provided inappropriately.


If implemented, the proposals would prevent more than 100,000 procedures a year and save an estimated £200m.


The proposals were developed by NHS England’s evidence-based interventions programme (EBIP), which includes NHS Clinical Commissioners, the Academy of Medical Royal Colleges (AoMRC), NHS Improvement and the National Institute for Health and Care Excellence (NICE).


The proposals are subject to a consultation that is scheduled to close on 28 September.


Under the evidence-based interventions programme, four treatments (category 1) would not be routinely commissioned, with patients only able to access treatment following a successful individual funding request (IFR):

  • snoring surgery (in the absence of obstructive sleep apnoea)
  • dilatation and curettage for heavy menstrual bleeding
  • knee arthroscopy for patients with osteoarthritis
  • injections for non-specific low back pain without sciatica


A further 13 procedures (category 2) would only be commissioned when a tightened set of criteria are met. These are:

  • 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
  • danglion excision
  • trigger finger release
  • varicose vein surgery


A range of measures will be used to implement the new guidelines, including requiring clinicians to seek prior approvals for category 2 interventions and introducing zero payments for category 1 interventions.


Co-chair of NHS Clinical Commissioners Dr Graham Jackson said the move marked the start of an ambitious programme to focus on a range of interventions that should not be provided or only provided on the NHS in certain circumstances.


The Health Service Journal has reported that NHS England plans to ‘rapidly expand’ the number of medications and treatments it will restrict access to — beyond those which have already been announced or formally proposed.


At NHS England’s board meeting this week a paper stated that the recently announced plan to cut access to 17 treatments will be part of ‘a much wider, ongoing programme, subject to making sufficient progress in the first phase’.


Further information

Health Service Journal: NHS to ‘rapidly expand’ treatment restrictions

NHS England: Board paper: Developing the NHS long term plan: evidence based interventions

NHS England: Consultation: evidence-based interventions programme