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

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OPCS Condition Criteria Source of advice Remarks B30.- Breast -Prosthesis Removal or Replacement R17.- Caesarian Section (CS) - Elective Should NOT be used EXCEPT if the NHS performed the original surgery and complications arise. Should NOT be used EXCEPT in the following circumstances: • A term singleton breech (if external cephalic version is contraindicated or has failed) • A twin pregnancy with breech first twin • HIV (only if recommended by a HIV consultant) • Both HIV and hepatitis C (as above, there is no evidence that CS should be performed for hepatitis C alone) • Primary genital herpes in the third trimester (active genital herpes at the onset of labour) • Grade 3 and 4 placential praevia • Two previous caesarian sections or ery/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/ publications/healthcommi ssion/policies/plasticsurg ery/plasticsurgerye.pdf NICE Clinical Guideline 13 http://www.nice.org.uk/pa ge.aspx?o=113190 access to a trained bra fitter and introducing laser scanning of the thorax). Patients should be made aware that implant removal in the future might not be automatically followed by replacement of the implant. If revisional surgery is being carried out for implant failure, the decision to replace the implant(s) rather than simply remove them will be based upon the clinical need for replacement and whether the patient meets the policy for augmentation at the time of revision. When considering a CS, there should be a discussion on the benefits and risks of CS compared with vaginal birth specific to the woman and her pregnancy. Maternal request is not on its own an indication for CS and specific reasons for the request should be explored, discussed and recorded. When a woman requests a CS in the absence of an identifiable reason, the overall benefits and risks of CS compared with vaginal birth should be discussed and recorded. 46
OPCS Condition Criteria Source of advice Remarks J18.- C13.1 C13.2 C13.3 C13.4 C13.8 C13.9 C15.1 C15.2 C12.1 C12.2 C12.3 C12.4 C12.5 Cholecystectomy (for asymptomatic gall stones) Eyelid - Blepharoplasty more • Previous upper segment caesarean section or type unknown • Previous significant uterine perforation/ surgery breaching the cavity Should NOT be used EXCEPT in patients who are at increased risk of developing gallbladder carcinoma or gallstone complications Surgery on the upper eyelid should NOT be used EXCEPT to correct functional impairment (not purely for cosmetic reasons), as demonstrated by: • Impairment of visual fields in the relaxed, non-compensated state. • Clinical observation of poor eyelid function, discomfort e.g. headache worsening towards the end of the day and / or evidence of chronic compensation through elevation of the brow. Surgery on the lower eyelid should NOT be used EXCEPT for: • correction of ectropion or entropion • for the removal of lesions of the eyelid Public Health Wales Evidence-Based Information http://www2.nphs.wales.n hs.uk:8080/healthservice qdtdocs.nsf/PublicPage? OpenPage 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/ publications/healthcommi ssion/policies/plasticsurg ery/plasticsurgerye.pdf There is insufficient evidence of clinical effectiveness of cholecystectomy (for asymptomatic gall stones). Excess skin in the upper eyelids can accumulate due to the ageing and is thus normal. Hooded lids causing significant functional impaired vision confirmed by an appropriate specialist can warrant surgical treatment. Impairment to visual field to be documented Excessive skin in the lower lid may cause “eye bags” but does not affect function of the eyelid or vision and therefore does not need correction. 47
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
Page 9 and 10: Section 3 - Funding Application Pro
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
Page 17 and 18: 6.4 On receipt of this corresponden
Page 19 and 20: Section 8 - Communications Strategy
Page 21 and 22: APPENDIX 1 LOW EFFECTIVENESS PROCED
Page 23 and 24: OPCS Condition Criteria Source of a
Page 25 and 26: OPCS Condition Criteria Source of A
Page 41: OPCS Condition Criteria Source of A
Page 54 and 55: 6. Health Commission Wales. Cochlea
Page 56 and 57: Available at: http://www2.nphs.wale
Page 58 and 59: http://www.wales.nhs.uk/sites3/Docu
Page 60 and 61: Questions Comments / Explanation (m
Page 62 and 63: Questions Comments / Explanation (m
Page 64 and 65: Has the application been approved b
Page 66: Date of IPC Panel For LHB Use Only

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