NHS Blackburn with Darwen Clinical Commissioning Group (CCG) buys the majority of healthcare services on behalf of the local population. The money for this comes from a fixed budget and by law, we are required to keep within this budget. Unfortunately, demand for healthcare is greater than can be funded from this fixed budget. It means therefore, that some healthcare which patients might wish to receive, and which your doctor or specialist might wish to offer, cannot be funded.
What is PLCV?
Some routine treatments are now described as ‘Procedures of Limited Clinical Value’ (PLCV). These are procedures which national experts have suggested have only limited or temporary benefit, and which are not felt to be necessary to maintain good health. This means they need to be considered on a case by case basis and meet strict criteria before they can be funded by the NHS.
What this means for you
This may mean that your doctor is not able to offer you a certain treatment because it is not funded on the local NHS. Although most doctors recognise the need to stay within a fixed budget, they may be uncomfortable with this policy because of its implications for you as a patient. Even so, your doctor is required to observe the policy, because the local NHS has put it into effect. It is the best way to ensure that local NHS funds are spent on the things that will bring greatest overall benefit to local people in a way that is affordable and fair.
Which treatments are affected?
The following are just some examples of treatments that are classed as Procedures of Limited Clinical Value and currently not funded or are restricted:
- Complimentary therapies i.e. Hypnosis, Reiki, Aromatherapy – Not Funded
- Acupuncture – for non-specific low back pain only – Restricted
- Grommets, tonsillectomy, adenoidectomy, surgery for sleepapnoea – Restricted
- Surgery for snoring – Not Funded
- Hysterectomy for heavy menstrual bleeding – Restricted
- Cataracts – Restricted
- Circumcision – Restricted
- Haemorrhoidectomy – Restricted
- Inguinal hernia repair – Restricted
- Test for confirming Irritable Bowel Syndrome in adults – Restricted
- Back surgery and injections – Restricted
- Surgery for Dupuytrens, Removal of Ganglion, and Joint Injections – Restricted
A list of policies of all treatment policies can be found on the CCG website at: http://www.blackburnwithdarwenccg.nhs.uk/about-us/policies-procedures/
What if I am not happy with the decision?
Decisions are based on strict medical criteria and so are usually clear-cut. If you are not happy with the decision, you can ask your doctor to apply again with more medical information. The decision is based on medical evidence, so if you submit new evidence your case will be re-examined.
Compliments, comments and complaints
The Customer Care team can offer help and support and provide you with a copy of the Commissioning Policy for Procedures of Limited Clinical Value. The Customer Care team can be contacted on the following:
Customer Care Team, Jubilee House, Lancashire Business Park, Leyland, PR26 6TR ; Freephone: 800 032 2424; Telephone: 01772 777952; Textphone: 01772 227005; Email: firstname.lastname@example.org
Is this about saving money?
No. The quality of care given to patients is the most important factor for these policies, not money. We want to ensure we offer affordable treatments which are in-line with the latest available evidence. We recognise there will be exceptional, individual or clinical circumstances when funding for these treatments may be appropriate.
Patient leaflet POLICY FOR PROCEDURES OF LIMITED CLINICAL VALUE (pdf | 1.2 MiB)