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NHS treatment restrictions

Why cuts to NHS Haemorrhoid operations might be the cut that hurts the most.

Recent News has revealed that the NHS plans to cut back on the routine commissioning of surgical haemorrhoid procedures. Haemorrhoid surgery is just one of the 17 procedures effected, in a bid to save the NHS £200 million a year. But more than 8 million people suffer from symptoms caused by haemorrhoids. This has caused concerns and questions amongst patients and the public. Why has haemorrhoid surgery been discontinued? What are my options if I, or someone I know, is living with haemorrhoids?

When will these proposals be implemented?

Alongside treatments such as a tonsillectomy and a breast reduction, haemorrhoid surgery is among those that will be offered to far fewer patients under the new NHS England proposals. NHS England’s discussions on these are due to finish on 28 September 2018, with local health bodies deciding when to implement them from 2019 (The Sun, 2018).

Why are haemorrhoid procedures going to be offered to fewer patients?

NHS England has maintained that, by tightening the criteria, millions of pounds every year will be saved as well as ensuring patients receive the best treatment. These are difficult decisions for the NHS given the need for efficiency in an increasingly difficult economic climate. Speaking about the plans, National Medical Director of NHS England Professor Stephen Powis said that surgery is sometimes better avoided given that often the “risks and harms outweigh the benefits.” He goes on to say that “By reducing unnecessary or risky procedures for some patients we can get better outcomes while reducing waste and targeting resource to where it is most needed. ” (NHS England, 2018)

How will this effect haemorrhoid sufferers?

The NHS currently carries out three types of surgical interventions for haemorrhoids; a haemorrhoidectomy, haemorrhoidal artery ligation and stapling (NHS Website). However, the NHS is now advocating for the non-surgical alternatives that are available. Surgical procedures will only be carried out if certain clinical criteria are met. According to The Association of Coloproctology, surgery will only be undertaken in cases of persistent grade 1 or grade 2 haemorrhoids that have not improved from non-surgical interventions such as dietary changes or banding. Similarly, surgery may be performed on grade 3 or 4 haemorrhoids or those with a ‘symptomatic external component’.

Despite the changes resulting in savings and efficiencies, they will undoubtedly affect the 8 million sufferers living with haemorrhoids. The symptoms of living with haemorrhoids can be detrimental to these individuals. The condition if often joked about however living with it can be incredibly stressful. Sufferers can find it difficult to talk about the symptoms. A typical example of this comes from Robert B from Yorkshire. Speaking about his experience of haemorrhoids before his eXroid electrotherapy treatment he said he went through the ‘embarrassment of bleeding through [his] clothing” and “constant pain and itchiness”.

These changes make it vital for patients living with haemorrhoids to understand how else they can manage the condition if they don’t currently meet the criteria for surgery. Dr Hudson-Peacock, Medical Director at eXroid, advises patients to try changing their diet, particularly if constipation is thought to be the cause of the haemorrhoids. You can do this by increasing the amount of fibre in your diet via sources such as fruit, bread and cereal. Dr Hudson-Peacock also advises patients to try over-the-counter medication such as creams and ointments that don’t require a prescription to relieve swelling and discomfort.

If symptoms persist or worsen, patients will still be able to access NHS haemorrhoid treatments. Alternatively, if patients don’t want to wait or no longer meet the NHS criteria they can access private treatments available for a quick, easy fix. eXroid’s electrotherapy treatment is a fast, effective, NICE approved treatment for haemorrhoids. A gentle current is applied to the base of the haemorrhoid for up to 10 minutes and there is no need for anaesthetic. Many patients feel instant relief as soon as they walk out of the clinic. For more information on eXroid’s electrotherapy treatment, please visit here.

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