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
| Grampian | | Rationing introduced for Orione Hernia Briefs. | | | |
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.