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Cuts to NHS Haemorrhoid operations. What are your options?

In 2019, the NHS consultation to cut back on the routine commissioning of surgical haemorrhoid procedures was implemented. Haemorrhoid surgery is just one of the 17 procedures affected, in a bid to save the NHS £200 million a year. In the UK, 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?

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When were the proposals implemented?

In April 2019 the NHS implemented the outcomes of a consultation it conducted in 2018 (Consultation Document) to which treatments will and won’t be funded. Alongside treatments such as tonsillectomy and breast reduction, haemorrhoid surgery is among those that will be offered to far fewer patients under the new NHS England guidelines through Clinical Care Groups (CCGs).

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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)

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How will this affect haemorrhoid sufferers?

A shift from Theatre to Clinic

The guidance clearly stipulates that the evidence shows that clinic based treatments for grade I,II, and III haemorrhoid can be more effective than theatre based surgery and should be considered as a leading option for treatment.

The NHS currently carries out three types of surgical interventions for haemorrhoids; a haemorrhoidectomy, haemorrhoidal artery ligation and stapling (NHS UK). However, the NHS is now advocating for the non-surgical procedure alternatives that are available in clinic. 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’.

Impact on Patients

Despite the changes resulting in savings and efficiencies, there will undoubtedly be an effect on the 8 million UK sufferers living with haemorrhoids. The symptoms of living with haemorrhoids can be detrimental to these individuals. The condition is often joked about. 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.

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Our Advice

Dr Hudson-Peacock, Medical Director at eXroid, advises patients to seek support from their GP practice and try changing their diet, particularly if constipation is thought to be the cause of the haemorrhoids. This may often be done by simply increasing the amount of fibre in your diet via sources such as fruit, vegetables, wholemeal products and cereal. Dr Hudson-Peacock also advises speaking to your pharmacist to get advice on over-the-counter medication such as creams and ointments that don’t require a prescription to relieve swelling and discomfort. If these remedies do not provide the relief you seek, you should consider a non-surgical procedure, such as eXroid.

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Can I get haemorrhoid electrotherapy on the NHS?

eXroid’s electrotherapy has been evaluated and recommended by NICE as an effective treatment for grade I, II, and III haemorrhoids. As a clinic-based, fully ambulatory (walk-in, walk-out) procedure, it is fully compliant with the NHS Commissioning Guidelines 2019. eXroid is working with NICE and individual NHS CCG commissioning groups to make the treatment available in your area. Please see the ‘commissioned services’ section on your local CCG website for more information. We would encourage you to contact us for help and support, if your local CCG does not commission the eXroid electrotherapy treatment in your area.

Speak to one of our experienced advisors. All enquiries are handled with complete discretion.