NHS Blackburn with Darwen CCG

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Lancashire-wide review and harmonisation of clinical policies

In the NHS treatments and care for patients are provided free at the point of service. While in hospital and for certain categories of patient, medications are also free at the point of service. However, not all treatments and medications are routinely funded by the NHS. This is because the effectiveness of certain procedures and medications can vary amongst patients and in these cases can do more harm than good. It is also possible for the population to be given excessive healthcare that weakens its self-reliance and independence while receiving little or no healthcare benefit.

In addition, the NHS must make sure it is using its limited resources to maximum benefit for each patient it treats and the population it serves as a whole. It must also ensure it is using the most effective and accepted medical procedures. NHS Clinical Commissioning Groups (CCGs), as local guardians and commissioners of the NHS, must prioritise the services it is able to fund and commission. This means making decisions about which healthcare services will and will not be provided under the NHS in their area.

The eight Clinical Commissioning Groups in Lancashire (please see below) are working together to review their clinical policies. They are seeking to make clinical decisions and the individual funding request process consistent and fair across Lancashire. As part of this process clinical policies are being amended and updated and brought into line wherever possible across the CCGs. This includes reviewing the principles upon which all the policies are based.

The clinical commissioning groups in Lancashire are:

NHS Blackburn with Darwen
NHS East Lancashire
NHS Lancashire North
NHS West Lancashire
NHS Fylde and Wyre
NHS Blackpool
NHS Greater Preston
NHS Chorley and South Ribble

Polices currently being reviewed and consulted on are:

• Policy for the Surgical Treatment of Carpel Tunnel Syndrome
• Policy for Tonsillectomy/Adeno-Tonsillectomy
• Policy for the Surgical Release of Trigger Finger
• Policy for the Management of Otitis Media with Effusion (OME) using Grommets (the treatment of glue ear in children)
• Policy for Breast Reduction Surgery (separated from the existing Cosmetics policy)
• Policy for the Surgical Management of Gynaecomastia (enlarged male breasts) – separated from the existing Cosmetics policy
• Policy for the Removal of Benign Skin Lesions (separated from the existing Cosmetics policy)

To read these policies and provide your comments and feedback please click on the link below, which will take you to the Healthier Lancashire policy review webpage. You will be asked to complete a short survey for each policy you wish to provide feedback on. You will also find a level of change document, giving details of the changes between the amended policies and the original policies, and a Frequently Asked Questions document on the policy review webpage.


The public engagement for these policies will close on Monday 1 July.

Policies that have been reviewed and consulted on are:

Adult snoring surgery (in the absence of obtructive sleep apnoea)
Arthroscopic shoulder decompression (shoulder) for subacromial pain
Assisted Conception
Chalazia removal
Complementary and Alternative Therapies Public Engagement Outcomes
Cosmetic Procedures
Dilatation and Curettage
Dupytren’s contracture release in adults
Endoscopic Procedures of the Knee Joint Cavity
Excision of Uterus
Ganglia excision
Haemorrhoid surgery
Hip Arthroscopy
Insulin Pumps
Male Circumcision
Management of Otitis Media with Effusion (OME) using grommets
Photorefractive Error
Provision of Continuous-Flash Glucose Monitors
Rehab after damage to Facial Nerve
Spinal injections for low back pain
Sterilisation reversal in males and females
Surgical Release of Trigger Finger
Surgical Treatment of Carpel Tunnel Syndrome
Treatment of varicose veins
Views on changes to clinical policies