Tonsillectomy - NHS North Somerset

TREATMENT UNDER THIS POLICY REQUIRES PRIORAPPROVAL FROM THE PCTTHIS POLICY RELATES TO ALL PATIENTSNHS North SomersetReferral for Assessment for Tonsillectomy - Adults and ChildrenPolicy Statement : Date of Issue: 20 May 2011This policy addresses referral of adults and children for assessment wheretonsillectomy may be an appropriate option.Policy RestrictionsRecurrent Sore ThroatNHS North Somerset will provide funding approval for a referral to ENTconsultants for consideration, and subsequent provision of, a tonsillectomy forpatients with recurrent sore throat if the following criteria are met:• The patient has five or more episodes of tonsillitis per year for two consecutiveyears or seven episodes in one year.• Symptoms have been occurring for at least a year.• The episodes of sore throat are disabling and cause significant functionimpairment. Significant functional impairment is defined by NHS NorthSomerset as:o Symptoms prevent the patient fulfilling vital work or educationalresponsibilitieso Symptoms prevent the patient carrying out vital domestic or careractivitiesEvidence to support the request including dates of episodes of tonsillitis must berecorded in the Patient’s clinical notes.Other ConditionsNHS North Somerset will provide funding approval for a referral to an ENTconsultant who will assess whether surgery is likely to result in a substantial andsustained improvement in health, and subsequent provision of a Tonsillectomy ifso, for Patients with the following conditions:• A quinsy requiring hospital admission associated with tonsillitis• Children with symptoms of obstructive sleep apnoea associated with tonsillitis• Psoriasis exacerbated by tonsillitis, referred via a Consultant DermatologistSore throat associated with stridor or respiratory difficulty is an absoluteindication for admission to hospital.Note: Patients who are not eligible for treatment under this policy may beconsidered on an individual basis where their GP or consultant believesexceptional circumstances exist that warrant deviation from the rule of thispolicy.1 of 2

Individual cases will be reviewed at the PCT Individual Commissioning Panelupon receipt of a completed application form from the patient’s GP, Consultantor clinician. Applications cannot be considered from patients personally.Approved by (committee)CAF/PECDate Approved: 14 April 2011 Version 2.0Produced by (Title); Individual Commissioning ManagerReview Date:ReferencesEarliest of either SHA guidance, NICE publication or one year fromissue.SIGN No. 34 (1999) – Management of Sore Throat and Indications for TonsillectomyRoyal College of Paediatrics and Child Health. RCPCH guidelines for good practice: management of acute andrecurring sore throat and indications for tonsillectomy. Available at:http://www.rcpch.ac.uk/doc.aspx?id_Resource=1714