Overcoming barriers in hallux valgus surgery

NewsBot · Oct 20, 2020

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Overcoming barriers in hallux valgus surgery: an assessment of variation in clinical commissioning in England
Duncan Coffey, Raju Ahluwalia, Sarah Hudson-Phillips, Calum Clark, Kent Keli Dusu, Andrew Gaukroger, Stella Vig
British Journal of Healthcare ManagementVol. 26, No. 10 Research:15 Oct 2020

Background/Aims
In 2014, the Royal College of Surgeons expressed concern that a postcode lottery was determining the commissioning of procedures of limited clinical value. The research was carried out to assess whether there is variation in the clinical commissioning of hallux valgus surgery in England.

Methods
The commissioning policies for clinical commissioning groups were identified. Data were analysed to assess both adherence to the British Orthopaedic Association guidelines for surgery and the minimum criteria that a patient must fulfil for surgery.

Results
Variation was recorded in commissioning policies and in the number of criteria a patient must fulfil to be offered surgery.

Conclusions
There is currently no standardised national commissioning policy for hallux valgus surgery. Referral guidelines have been produced by leading national bodies but their implementation is varied. This can lead to variation in referral patterns in England for patients requiring hallux valgus surgery.
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