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

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OPCS Condition Criteria Source of advice Remarks E02.3 E02.5 E02.6 E07.3 F14.- F15.- F34.1 F34.2 F34.3 F34.4 F34.5 F34.6 F34.7 Nose - Rhinoplasty Orthodontic treatments of essentially cosmetic nature Tonsillectomy – children & adults • The woman no longer wishes to retain her uterus and fertility Should NOT be used EXCEPT for: • Problems caused by obstruction of the nasal airway. • Objective nasal deformity caused by trauma. • Correction of complex congenital conditions e.g. cleft lip and palate. Priority will be based on those with high Index of Orthodontic Treatment Need Scores - 5,4 and 3 where a significant aesthetic component can be demonstrated and those with other major conditions e.g. craniofacial deformity/cancers Should NOT be used EXCEPT if patients meet ALL of the following criteria prior to referral: • Sore throat is due to tonsillitis • Five or more episodes of sore throat per year 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 Health Evidence Bulletin Wales Oral Health http://hebw.cf.ac.uk/oralh ealth/index.html Royal College of Paediatrics and Child Health. Guidelines for good practice. Management of acute and recurring sore throat and indications for Patients with isolated airway problems (in the absence of visible nasal deformity) may be referred initially to an Ear Nose and Throat (ENT) consultant for assessment and treatment. Evidence based on expert opinion suggests that orthodontic treatment should be directed at those individuals in which the greatest benefit can be achieved. Once a decision is made for tonsillectomy, this should be performed as soon as possible, to maximise the period of benefit before natural resolution of symptoms might occur Tonsillectomy is one of the five surgical 50
OPCS Condition Criteria Source of advice Remarks F34.8 F34.9 L84.- L85.- L86.- L87.- L88.- F09.1. F09.3. Varicose Veins – asymptomatic & mild/moderate cases Wisdom teeth - Removal of asymptomatic • Symptoms for at least one year • Episodes of sore throat are disabling and prevent normal functioning A six-month period of watchful waiting is recommended prior to tonsillectomy to establish firmly the patterns of symptoms and allow the patient to consider fully the implications of the operation Should NOT be used EXCEPT in the following circumstances: • ulcers/history of ulcers secondary to superficial venous disease • liposclerosis • varicose eczema • history of phlebitis Should NOT be used EXCEPT in cases where there is evidence of pathology tonsillectomy. http://www.rcpch.ac.uk/do c.aspx?id_Resource=171 4 Referral Advice National Institute for Clinical Excellence. http://www.nice.org.uk/m edia/A8F/DC/Referraladvi ce.pdf London Health Observatory http://www.lho.org.uk/co mmissioning/PCTClinical Exceptions.aspx NICE Technology Appraisal 1 http://guidance.nice.org.u k/TA1 London Health Observatory http://www.lho.org.uk/co mmissioning/PCTClinical procedures that the Department of Health monitors as indicators of excess surgical activity. Evidence from recent population surveys indicates very little relationship between symptoms and varicose veins – substantial numbers of patients without varicose veins have similar symptoms Most varicose veins require no treatment. The most common complaint about varicose veins is their appearance. When bleeding or ulceration occurs referral may be appropriate and of that number some may benefit from surgical intervention. Impacted wisdom teeth free from disease should not be operated on. 51
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
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Page 56 and 57: Available at: http://www2.nphs.wale
Page 58 and 59: http://www.wales.nhs.uk/sites3/Docu
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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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