Hernia repair policy for each CCG

NHS Guidelines  - What you need to know...

NICE Guidance states that surgical hernia repair 'should be undertaken in most individuals presenting with an inguinal hernia' and this is also similar advice to the Royal College of Surgeons (RCS). However, the Clinical Commissioning Groups  (CCG's) in charge of the provision of herniorraphy/hernioplasty techniques within your own UK health boundary do not always follow national guidelines.

A report by the Hernia Outcomes Group state that over half of CCG's in England are reducing access to hernia repair surgery. This invariably results in longer wait times (2017 is 40% higher than 2016 according to NHS statistics reported in The Guardian newspaper).

In the recent Royal College of Surgeons report entitled 'Is access to surgery a postcode lottery?' the somewhat variable policies of Clinical Commissioning Groups (CCG's) to Inguinal hernia surgery were measured. There was wide variance between the Royal College of Surgeons (RCS) guidance that states that 'surgical repair should be offered to all patients presenting with symptomatic hernias'. 

The report found that only 27% of CCG's surveyed comply with RCS / NICE guidelines. Some CCG's require a hernia size increase or incarceration history before they will consider surgery;a policy with potential issues for risk and surgical outcome not to mention patient discomfort.

BBC Radio 4's Inside Health programme on 1st Feb 2017 describes this policy and its shortcomings.  Download to listen. (25Mb .mp3 file)

Below is the complete list of CCGs in NHS England and their policy (if any) at time of writing (March 2015).
We invite customers to help us complete the columns if you know the policy in your area to help other people. Thank you!  
 

CCG Name	'Watchful Waiting' Policy	'Incarceration History/Size increase' Policy	Follow NICE/RCS Guidelines	Unknown Policy
Airedale Wharfdale and Craven
Ashford
Aylesbury Vale
Barking & Dagenham
Barnet
Barnsley
Basildon and Brentwood
Bassetlaw
Bath and North East Somerset
Bedfordshire
Bexley
Birmingham Crosscity
Birmingham South and Central
Blackburn With Darwen
Blackpool
Bolton
Bracknell and Ascot
Bradford City
Bradford Districts
Brent
Brighton & Hove
Bristol
Bromley
Bury
Calderdale
Cambridgeshire and Peterborough
Camden
Cannock Chase
Canterbury and Coastal
Castle Point and Rochford
Central London (Westminster)
Central Manchester
Chiltern
Chorley and South Ribble
City and Hackney
Coastal West Sussex
Corby
Coventry and Rugby
Crawley
Croydon
Cumbria
Darlington
Dartford Gravesham and Swanley
Doncaster	NOT AVAILABLE	ON PRESCRIPTION
Dorset
Dudley
Durham Dales Easington and Sedgefield
Ealing
East and North Hertfordshire
East Lancashire
East Leicestershire and Rutland
East Riding of Yorkshire
East Staffordshire
East Surrey
Eastbourne Hailsham and Seaford
Eastern Cheshire
Enfield
Erewash
Fareham and Gosport
Fylde & Wyre
Gateshead
Gloucestershire
Great Yarmouth & Waveney
Greater Huddersfield
Greater Preston
Greenwich
Guildford And Waverley
Halton
Hambleton Richmondshire and Whitby
Hammersmith and Fulham
Hardwick
Haringey
Harrogate and Rural District
Harrow
Hartlepool & Stockton-On-Tees
Hastings & Rother
Havering
Herefordshire
Herts Valleys
Heywood Middleton & Rochdale
High Weald Lewes Havens
Hillingdon
Horsham and Mid Sussex
Hounslow
Hull
Ipswich and East Suffolk
Isle Of Wight
Islington
Kernow
Kingston
Knowsley
Lambeth
Lancashire North
Leeds North
Leeds South and East
Leeds West
Leicester City
Lewisham
Lincolnshire East
Lincolnshire West
Liverpool
Luton
Mansfield & Ashfield
Medway
Merton
Mid Essex
Milton Keynes
Nene
Newark & Sherwood
Newbury and District
Newcastle North and East
Newcastle West
Newham
North & West Reading
North Derbyshire
North Durham
North East Essex
North East Hampshire and Farnham
North East Lincolnshire
North Hampshire
North Kirklees
North Lincolnshire
North Manchester
North Norfolk
North Somerset		Restricted low clinical value for hernia repair.
North Staffordshire
North Tyneside
North West Surrey
North East West Devon
Northumberland
Norwich
Nottingham City
Nottingham North & East
Nottingham West
Oldham
Oxfordshire
Portsmouth
Redbridge
Redditch and Bromsgrove
Richmond
Rotherham
Rushcliffe
Salford
Sandwell and West Birmingham
Scarborough and Ryedale
Sheffield
Shropshire
Slough
Solihull
Somerset
South Cheshire
South Devon and Torbay
South East Staffs and Seisdon Peninsular
South Eastern Hampshire
South Gloucestershire
South Kent Coast
South Lincolnshire
South Manchester
South Norfolk
South Reading
South Sefton
South Tees
South Tyneside
South Warwickshire
South West Lincolnshire
South Worcestershire
Southampton
Southend
Southern Derbyshire
Southport and Formby
Southwark
St Helens
Stafford and Surrounds
Stockport
Stoke On Trent
Sunderland
Surrey Downs
Surrey Heath
Sutton
Swale
Swindon
Tameside and Glossop
Telford & Wrekin
Thanet
Thurrock
Tower Hamlets
Trafford
Vale Of York
Vale Royal
Wakefield
Walsall
Waltham Forest
Wandsworth
Warrington
Warwickshire North
West Cheshire
West Essex
West Hampshire
West Kent
West Lancashire
West Leicestershire

NHS Scotland

We invite customers to help us complete the columns if you know of the policy in your CCG area. This will help others make informed decisions.
 Thank you.