View 2019 Abstracts

To evaluate clinicians’ experiences of CCG-imposed funding restrictions and access policies for oculoplastic procedures, and the perceived impact on patients and staff.

An online survey was sent to all full BOPSS members. Questions investigated access policy for each procedure; who was involved in developing access criteria; logistics of funding applications; perceptions on ease of interactions with the CCG; and benefits and challenges of CCG policies.

29 responses were received. Key findings were:
Only 24% were involved with drafting local policies; of these, most felt some weight was given to their opinion and agreed in part with the final policy, but 2 did not agree at all with their CCG’s final policy. 35% find policies hard to follow, and 31% do not think their CCGs deal with applications fairly. However, 52% find the policies helpful when declining those unsuitable for NHS surgery. 62% said funding restrictions had prevented them undertaking an indicated procedure. 21% feel a patient has come to harm due to inability to access funding.
Almost half reported that GPs refer most patients without funding. 48% spend more than 15 minutes a week on funding applications, and 25% more than 30 minutes.

Policies to restrict funding of ‘low priority procedures’ may be necessary in these times of NHS hardship, but there appears to be something of a ‘postcode lottery’ in clinicians’ experience of using them. We propose that more input from oculoplastic consultants during drafting of policies and more reference to clinical evidence, as well as setting national rather than regional criteria, would make CCGs’ policies more helpful, and reduce risk of harm to patients.