Restricting access to groin surgery leaving patients in pain

A new report has argued that thousands of patients are being made to suffer in pain because of the NHS restricting access to groin (inguinal) hernia operations.

The Royal College of Surgeons and the British Hernia Society report that 57 per cent of clinical commissioning groups (CCGs) are denying patients quick access to the procedure, despite surgery being the only curative treatment for patients with a groin hernia. A groin hernia can cause pain and lead to severe complications if untreated.

Approximately 78,733 groin hernia procedures were carried out in hospitals in England in 2016-17, with 3,700 of these patients having to be operated on in emergency because their symptoms were so serious. According to the two health bodies, if a patient is treated as an emergency the mortality rate is seven times higher than elective hernia surgery.

David Sanders of the British Hernia Society said: “The decision to operate should always be taken in consideration of the risks and benefits after full discussion with the patient. It is simply not acceptable to justify restrictive criteria as best practice. This denies patients access to a procedure that potentially limits pain and improves quality of life.

“Hernias do not increase in size in a smooth fashion, with some months seeing significant growth and others seeing limited or no growth. This makes it difficult to assess, using a blunt CCG policy, exactly when a patient may require surgery. Additionally, a patient may not have a history of incarceration but could still suffer from debilitating pain that can have an impact on his or her quality of life. The NHS has to be very clear about what it offers. Does it want a value for money service with quality and safety as a priority, or a rationed service that will inevitably put some patients at risk?"

Susan Hill, senior vice president of the Royal College of Surgeons, said: “It is an absolute disgrace that some patients have to demonstrate what could be a life-threatening complication of a hernia, which is one of the most straightforward surgical conditions to treat. Instead of asking patients to prove their pain, Ministers and NHS England should immediately intervene to allow patients to talk to their surgeon about whether they need an operation. Allowing commissioning groups, not patients with their surgeon, to make a decision to operate is putting patients at unnecessary risk of serious complications.”

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