I would like the government to provide funding for surgical correction of Pectus Excavatum on the NHS, following the decision by NHS England not to include it in its commissioning policy.
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In 2019 NHS England published a clinical commissioning policy for surgery for pectus deformity in all ages. (NHS England Reference: 170113P).It stated that NHS England will not routinely commission surgery for pectus deformity. The justification was that on reviewing the evidence it was concluded that the clinical trials were not set up to show a clear clinical benefit of surgical intervention. This doesn't mean that patients haven't and wouldn't benefit from it clinically and psychologically.
Friday 22nd January 2021
The current position of NHS England, with whom commissioning decisions sit, is not to provide funding for surgical correction of Pectus Excavatum, though individual funding requests can still be made.
Decisions on the commissioning of specialised interventions, such as for the surgical correction of pectus excavatum/pectus deformity sits with NHS England, and therefore the Government cannot intervene in individual commissioning decisions. It is right that all decisions on treatment should be made by clinical experts, informed by a patient's individual clinical needs. Unfortunately, the NHS does not have unlimited resources, and it is right that clinical commissioners review their services to ensure they are providing the best possible care, balancing demand with supply, for the benefit of their patients and local populations.
In 2019, NHS England published a clinical commissioning policy paper, looking at surgery for pectus deformity. In NHS England’s review, they determined that there was not enough evidence to routinely commission surgical intervention for pectus deformity. The review looked at a range of factors, including the physical and psychological impact and quality of life experienced by patients.
As it stands, there are a range of treatments, both surgical and non-surgical, to manage pectus deformity, and patients can ask their clinician to refer them to a thoracic surgical clinic for advice.
There are a number of factors that are taken into account when deciding what treatment should be offered to an individual with pectus deformity. These include the type of pectus deformity, the degree of deformity, and determination of whether the deformity is isolated or part of a syndrome. In the majority of cases, surgical treatment is not offered as the physical or psychological symptoms are mild.
The Government does appreciate that for some individuals, pectus deformity can have a significant impact on their lives. Where a treatment or service that a patient needs is not offered routinely by the NHS, a clinician can make an individual funding request if they believe that a particular treatment or service is the best course of action given an individual’s clinical circumstances. An individual funding request can be made when a clinician believes that their patient is clearly different to other patients with the same condition or where their patients might benefit from the treatment in a different way to other patients.
Department of Health and Social Care