East and North Hertfordshire NHS service changes – decisions announced

East and North Hertfordshire NHS service changes – decisions announced

A special joint committee, made up of representatives from East and North Hertfordshire Clinical Commissioning Group and Herts Valleys Clinical Commissioning Group, met yesterday (Thursday 12 October) and made a number of decisions about NHS services in the county.

The decisions, made at a three-hour meeting held in public, followed a 10-week public consultation on a series of proposals, designed to make best use of the money and resources available to the local NHS and encourage people to live healthier lives, avoiding preventable illnesses.  All proposals were debated in full and the committee heard from members of the public who wanted to share their personal experiences of some of the issues.

The changes are:

  • Requiring people who smoke or whose weight is classified as obese to improve their health before they have non-urgent surgery – unless waiting for surgery would be more harmful.
  • Gluten- free food will not be available on prescription, with the exception of patients with learning disabilities or where there are welfare concerns.
  • Limiting the routine prescription of medicines, products and food supplements for short-term conditions and minor ailments, except in exceptional circumstances.  In future, people will need to buy these themselves from pharmacies or shops.
  • Female sterilisation will only be funded in exceptional circumstances, which would be assessed on a case‐by‐case basis if alternative forms of long‐acting contraception are unsuitable.
  • The CCG will only fund one cycle of IVF for patients who meet the criteria, this is a change from the previous policy, of funding up to three cycles.

During an extensive public engagement campaign - which included meetings, drop-in discussion events, press coverage and a social media campaign – thousands of online and postal responses were received from members of the public, special interest groups, clinicians, local wellbeing groups and providers of specialist fertility services. 

DR Hari Pathmanathan, CCG ChairDr Hari Pathmanathan, a Hertfordshire GP and Chair of East and North Hertfordshire CCG said:

“I would like to thank all those who have taken part in the consultation process.  The consultation proposals were developed by local GPs and public health doctors, with the best interests of the whole patient population of our area in mind.  These decisions haven’t been taken lightly and our conversations with the public have demonstrated that many people understand the challenges faced by the NHS in Hertfordshire and beyond. 

“Some of the changes we put forward for consideration have already taken place in other areas and some, like our gluten-free policy, are currently being considered nationally.  

“We understand that some of our patients will have to make changes and they will be supported to do so, for example with the free weight-loss and stop-smoking advice sessions already on offer.

“There is a significant level of public support for most of the changes that have been agreed – even from people who told us that they would be directly affected by the policy changes that we proposed.  Our fitness for surgery proposal is a good example of this – 84% of those who responded thought this would mean that they themselves would need to either stop smoking or lose weight if they needed a non-urgent operation, but agreed with this policy.” 

Dr Nicky Williams, Deputy Clinical Chair of East and North Hertfordshire CCG, and a Ware GP, said:

“These policy decisions will not take away any GP’s ability to make decisions based on the individual welfare needs of their patients, such as a child or someone whose wellbeing must be safeguarded.  GPs will also be able to refer individual cases to a specialist decision-making panel, if they feel that their patient faces unique clinical circumstances. 

“Most people in the East and North Hertfordshire CCG area who responded to our consultation told us that they wanted to retain some NHS funding for IVF and specialist fertility services, so I am pleased that our CCG has been able to do this, although provision has been reduced to one cycle.  I understand that those currently receiving specialist fertility treatment will be concerned about the implications for their care and they will be contacted to discuss their individual circumstances.

“East and North Hertfordshire CCG will now begin work on a detailed implementation and awareness-raising plan for all of these decisions, prioritising the needs of the patients who will be affected.”

ENDS

Notes to Editors

  1. The consultation proposals, responses received during the consultation and decisions made are as follows:

Fitness for non-urgent surgery

Consultation proposal:

Morbidly obese patients with a BMI over 40 would need to reduce their weight by at least 15% over 9 months or reduce their BMI to less than 40 (whichever is greater) before having non‐urgent surgery.

Public views:

Agree – 85%

Disagree – 15%

Consultation proposal:

Obese patients with a BMI over 30 will not get non‐urgent surgery until they reduce their weight by 10% over 9 months or reduce their BMI to less than 30.

Public views:

Agree – 73%

Disagree – 27%

Consultation proposal:

Smokers would be required to quit smoking before being referred for non‐urgent surgery, unless waiting for surgery would be more harmful for them.

Public views:

Agree – 85%

Disagree – 15%

Gluten-free food (GFF) on prescription

Consultation proposal:

Gluten-free food should not be available on prescription, with the exception of patients with learning disabilities or where there are safeguarding concerns.

Public views:

Agree – 77%

Disagree – 23%

Over-the-counter treatments, products and food 

Consultation proposal:

Limit the prescribing of medicines, products and food items that are available without a prescription from a high‐street pharmacy, registered online pharmacy, supermarket or shop for short-term self-limiting conditions

Exclusions to this policy would  include:

  • Where there are safeguarding concerns
  • patients with long term conditions, for example osteoarthritis and the need for regular pain relief

Public views:

Agree – 89%

Disagree – 11%

Female sterilisation

Consultation proposal:

Female sterilisation would only be funded in exceptional circumstances, which would be assessed on a case‐by‐case basis if alternative forms of long‐acting contraception are unsuitable.

 

Public views:

Agree – 62%

Disagree –37%

 (figures do not add up to 100% due to rounding)

IVF and specialist fertility treatments

Consultation proposal:

  • Review the funding of IVF and other specialist fertility treatments

Options for East and North Herts CCG area:

  1. Continue to fund the current number of cycles offered (three)
  2. Reduce to two cycles
  3. Reduce to one cycle
  4. Stop funding, except in exceptional circumstances
  5. Stop funding altogether

Public views – East and North Herts CCG area (see area guide in Notes to Editors):

Continue to fund three cycles – 45%

Reduce to two cycles – 18%

Reduce to one cycle – 12%

Stop funding, except in exceptional circumstances – 14%

Stop funding altogether – 10%

(figures do not add up to 100% due to rounding)

  1. NHS East and North Hertfordshire CCG is led by local doctors representing the needs of their patients and the views of their GP colleagues, as well as by lay members of the local community.  The CCG is responsible for planning, designing and buying health services for East and North Hertfordshire’s residents and monitoring the quality and effectiveness of those services.
     
  2. To read the full papers from the decision-making meeting, please visit: https://www.healthierfuture.org.uk/publications/2017/october/papers-for-joint-committee-meeting 
     
  3. To contact the East and North Hertfordshire CCG communications team, please email communications@enhertsccg.nhs.uk, or telephone 01707 685 140 during office hours.
     
  4. The following towns and villages are in the East and North Hertfordshire Clinical Commissioning Group area:

Ashwell

Baldock

Bishop’s Stortford

Broxbourne

Buntingford

Cheshunt

Cuffley

Goffs Oak

Hertford

Hitchin

Hoddesdon

Knebworth

Letchworth

Much Hadham

Puckeridge

Sawbridgeworth

Stanstead Abbotts

Stevenage

Waltham Cross

Ware

Watton at Stone

Welwyn

Welwyn Garden City

Whitwell