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Letters

Financial cuts limit numbers going under the knife in plastic surgery

Nader Henry, Ishan Radotra, Sheirin Khalil and Azzam Farroha
British Journal of General Practice 2019; 69 (680): 120. DOI: https://doi.org/10.3399/bjgp19X701465
Nader Henry
Health Education England West Midlands, University Hospitals Birmingham, NHS Foundation Trust, Queen Elizabeth Hospital Birmingham. Email:
Roles: Plastic Surgery ST3 Registrar
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  • For correspondence: naderhenry@doctors.org.uk
Ishan Radotra
Health Education England West Midlands, Sandwell and West Birmingham Hospitals NHS Trust, Sandwell District General Hospital.
Roles: Plastic Surgery ST3 Registrar
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Sheirin Khalil
Health Education England East of England, James Paget University Hospitals NHS Foundation Trust, James Paget University Hospital.
Roles: GP ST2 Registrar
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Azzam Farroha
Plastic and Reconstructive Surgeon, University Hospitals Birmingham, NHS Foundation Trust, Queen Elizabeth Hospital Birmingham.
Roles: Consultant Burns
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We were interested to read the editorial by McCartney and Finnikin about choosing NHS interventions wisely.1 As plastic surgery trainees, we often encounter dissatisfied patients turned away from clinic for procedures that are no longer NHS funded, and see consultant colleagues disappointed at being unable to practise many aspects of their speciality. The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) has issued commissioning guidelines for patients undergoing body-contouring procedures following massive weight loss. These procedures lead to sustained weight loss, as well as reducing the rate of other complications such as intertrigo,2 but are still deemed cosmetic by CCGs, and will be funded only if an Individual Funding Request (IFR) application proves exceptional clinical need.3 We think that we should be supporting patients wishing to undergo these operations. Beside psychological and medical benefits to patients, unnecessary appointments in general practice are thought to cost the NHS over £300 million a year.4

We wish to highlight the BAPRAS Massive Weight Loss Body Contouring UK commissioning guidelines.5 Encouraging patients to meet the criteria prior to referral can reduce unnecessary clinic appointments, re-referral, and patient dissatisfaction. Successful adherence to these guidelines will give the IFR the greatest chance of being accepted and allowing surgery to proceed.

  • © British Journal of General Practice 2019

REFERENCES

  1. 1.↵
    1. McCartney M,
    2. Finnikin S
    (2019) Evidence and values in the NHS: choosing treatments and interventions well. Br J Gen Pract, DOI: https://doi.org/10.3399/bjgp19X700313.
  2. 2.↵
    1. Balagué N,
    2. Combescure C,
    3. Huber O,
    4. et al.
    (2013) Plastic surgery improves long-term weight control after bariatric surgery. Plast Reconstr Surg 132(4):826–833.
    OpenUrl
  3. 3.↵
    1. NHS Birmingham CrossCity Clinical Commissioning Group
    (2016) Clinical Commissioning Group (CCG) procedures of lower clinical value policy 1st edn, http://staff.bhamsouthcentralccg.nhs.uk/plans-and-policies/doc_download/1698-ccg-plcv-policy (accessed 12 Feb 2019).
  4. 4.↵
    1. Practice Business
    (2017) Pointless GP appointments costing the NHS £306m. http://practicebusiness.co.uk/gp-appointments-costing-the-nhs-306m-a-year-blamed-on-admin-cuts/ (accessed 12 Feb 2019).
  5. 5.↵
    1. British Association of Plastic, Reconstructive and Aesthetic Surgeons
    (2017) UK commissioning guide: massive weight loss body contouring (Royal College of Surgeons of England, London), 2nd edn, http://www.bapras.org.uk/docs/default-source/commissioning-and-policy/rewrite-for-2017--final-version.pdf?sfvrsn=4 (accessed 12 Feb 2019).
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British Journal of General Practice: 69 (680)
British Journal of General Practice
Vol. 69, Issue 680
March 2019
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Financial cuts limit numbers going under the knife in plastic surgery
Nader Henry, Ishan Radotra, Sheirin Khalil, Azzam Farroha
British Journal of General Practice 2019; 69 (680): 120. DOI: 10.3399/bjgp19X701465

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Financial cuts limit numbers going under the knife in plastic surgery
Nader Henry, Ishan Radotra, Sheirin Khalil, Azzam Farroha
British Journal of General Practice 2019; 69 (680): 120. DOI: 10.3399/bjgp19X701465
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