Betsi Cadwaladr University Local Health Board ... - Health in Wales

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3. LOWER VOLUME procedures which should NOT be used by the NHS EXCEPT under strict criteria OPCS Condition Criteria Source of Advice Remarks W71.4 W85.3 G28.4 G30.1 G30.2 G30.2 G30.4 G30.8 G30.9 G71.6 X85.1 Autologus Chrondrocyte implantation for knee/ ankle problems caused by damaged articular cartilage Bariatric Surgery for morbid obesity Botulinum Toxin Should NOT be used EXCEPT in research studies that are designed to produce good quality information about the results of this procedure. See HCW policy for criteria Should NOT be used EXCEPT for the treatment of pathological conditions by appropriate specialists in cases of: • Frey’s syndrome. • Blepharospasm. • Cerebral Palsy. • Hyperhidrosis. NICE Technology Appraisal 89 http://www.nice.org.uk/pa ge.aspx?o=TA089 Public Health Wales Evidence-Based Information http://www2.nphs.wales.n hs.uk:8080/healthservice qdtdocs.nsf/PublicPage? OpenPage HCW policy is currently being revised and will be issued shortly Health Commission Wales. Commissioning Criteria – Plastic Surgery. Procedures of Low Clinical Priority/ Procedures not usually available on the National Health Service http://wales.gov.uk/dhss/p ublications/healthcommis Evidence suggests that ACI has most commonly been used as a treatment for cartilage defects in the knee. There are few studies of its use in other joints. There are uncertainties about the potential adverse effects of the procedure and long-term effectiveness. Botulinum toxin is not available for the treatment of facial ageing or excessive wrinkles.
OPCS Condition Criteria Source of Advice Remarks S02.1 S02.2 S02.8 S02.9 S03.1 S03.2 S03.3 S03.8 S03.9 Body Contouring - ‘Tummy Tuck’ (Apronectomy or Abdominoplasty) Body Contouring – Other e.g. Buttock lift, Thigh lift, Arm lift (brachioplasty) Should NOT be used EXCEPT for the following groups of patients who should have achieved a stable BMI between 18 and 25Kg/m2 and be suffering from severe functional problems: • Those with scarring following trauma or previous abdominal surgery. • Those who are undergoing treatment for morbid obesity and have excessive abdominal skin folds. • Previously obese patients who have achieved significant weight loss and have maintained their weight loss for at least two years. • Where it is required as part of abdominal hernia correction or other abdominal wall surgery. Should NOT be USED except in exceptional circumstances. sion/policies/plasticsurger y/plasticsurgerye.pdf Health Commission Wales. Commissioning Criteria – Plastic Surgery. Procedures of Low Clinical Priority/ Procedures not usually available on the National Health Service http://wales.gov.uk/dhss/p ublications/healthcommis sion/policies/plasticsurger y/plasticsurgerye.pdf Health Commission Wales. Commissioning Criteria – Plastic Surgery. Procedures of Low Clinical Priority/ Procedures not usually available on the National Maintenance of a stable weight is important so that the risks of recurrent obesity are reduced. If there is severe and disabling psychological distress as a result of abdominal wall scarring, psychological therapy should be the initial treatment. Severe functional problems include: • Recurrent intertrigo beneath the skin fold. • Experiencing severe difficulties with daily living i.e. ambulatory restrictions. • Where previous trauma or surgical scarring (usually midline vertical, or multiple) leads to very poor appearance and results in disabling psychological distress or risk of infection. • Problems associated with poorly fitting stoma bags. The functional disturbance of skin excess in these sites tends to be less than that in excessive abdominal skin folds and so surgery is less likely to be indicated except for appearance. 25
Page 1 and 2: Betsi Cadwaladr University Local He
Page 3 and 4: Section 1 - Introduction and Defini
Page 5 and 6: consistent and appropriate. This wi
Page 7 and 8: The default position should be that
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Page 11 and 12: efficacy; in doing so the Chief of
Page 13 and 14: 3.24 Any recommendation made by the
Page 15 and 16: A copy of the best practice guidanc
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Page 19 and 20: Section 8 - Communications Strategy
Page 21 and 22: APPENDIX 1 LOW EFFECTIVENESS PROCED
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Page 64 and 65: Has the application been approved b
Page 66: Date of IPC Panel For LHB Use Only

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