NHS England has recently recommended stopping funding some interventions and these include common hand surgery operations such as
carpal tunnel syndrome release, trigger finger release, Dupuytren surgery and the removal of ganglions.
These procedures have been classified as Category 2 procedures and should only be done when specific clinical criteria met.
As a clinician, I appreciate that many of the above procedures do cause significant functional limitations and will attempt to obtain funding for these to be preformed through the NHS whenever possible.
As with any procedure, we will of course offer and attempt nonoperative management in the first instance including activity avoidance, splinting, physiotherapy and on occasions corticosteroid injections.
However despite such conservative measures many of the above continue to cause problems and in such cases surgery is known and has been proven to be highly effective.
As a result of the above announcements form NHS England, I have seen an increase request for such surgery to be performed on a self-pay basis in the private sector.
While this is clearly an option for those patients who can afford to fund themselves this is not the case for the majority.
I would therefore suggest that patients should make every effort to demonstrate to their clinicians they have functional limitations as a result of the above conditions to obtained funding through the NHS.