Policies - North Yorkshire and York - HNY Policy and Pathway Repository

Policies

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Abdominoplasty (including repair of diastasis recti)

Adult oral nutritional supplements (ONS)

Angioplasty for percutaneous coronary intervention (PCI)

Appendicectomy in patients with suspicion of appendicitis

Arthroscopic hip surgery

Arthroscopic lavage and debridement (not routinely commissioned)

Arthroscopic shoulder decompression

Bariatric surgery

Benign skin lesion removal

Biological and bioequivalent/biosimilar medicines

Blood transfusion

Botulinum toxin A for chronic migraine

Botulinum toxin A for spasmodic dysphonia

Botulinum toxin A injections into the bladder wall

Botulinum toxin type A injection to masticatory muscles

Branded medicines prescribing

Branded-generic medicines prescribing

Breast asymmetry correction

Breast enlargement surgery (not routinely commissioned)

Breast prosthesis removal

Breast reduction surgery

Carotid artery imaging (screening)

Carpal tunnel syndrome release

Cataract surgery in adults

Chalazion removal

Cholecystectomy

Chronic anal fissure interventions (all ages) – Botulinum toxin injection, fissurectomy and lateral internal sphincterotomy

Cleft (split) earlobe surgery

Complementary alternative therapies

Continued continuous positive airway pressure (CPAP)

Continuous glucose monitoring

Corrective surgery, lens implants and laser treatment for refractive error (short or long sightedness, astigmatism)

Cosmetic / plastic surgery

Cystoscopy for uncomplicated lower urinary tract symptoms

Dilatation & curettage for heavy menstrual bleeding (not routinely commissioned)

Dupuytren’s contracture release in adults

Dynamic splinting using lycra suits or orthotics

Early endoscopic retrograde cholangiopancreatography (ERCP)

Elective caesarean section (non-clinical reasons)

Endoscopic thoracic sympathectomy

Epididymal cyst surgery

Exercise electrocardiogram (ECG) (not routinely commissioned)

Exogen ultrasound bone healing (exogen therapy)

Extra corporeal shockwave therapy (ESWT), ankle, elbow, heel, hip, shoulder (not routinely commissioned)

Eyelid surgery (blepharoplasty)

Face, neck and brow lifts (rhytidectomy)

Functional electrical stimulation (FES)

Gamete harvesting and storage (cryopreservation)

Gamete harvesting and storage (Cryopreservation)

Ganglion excision

Gastroelectrical stimulation (GES) / gastro neuromodulation (not routinely commissioned)

Gluten-free (GF) products

Grommets for glue ear in children

Haemorrhoid surgery

Hair removal by intense pulsed light (IPL), laser or electrolysis for hirsutism

Hair replacement technologies (not routinely commissioned)

Half dose verteporfin photodynamic therapy (PDT)

Hallux valgus (bunion) surgery

Health optimisation

Helmet therapy for treatment of positional plagiocephaly/brachycephaly in children

Hernia (inguinal) - repair of minimally symptomatic inguinal hernia

Hip and knee replacement

Hip arthroplasty (choice of implant)

Hydrocele correction (including hydrocelectomy, ligation of patent processus vaginalis and sclerotherapy)

Hyperhidrosis treatment with botulinum toxin

Hysterectomy for heavy menstrual bleeding

Ilizarov technique / Taylor spatial frame (TSF) (frame surgery)

Infusion therapy – chronic non-cancer pain (not routinely commissioned)

Injections for isolated lower back pain without sciatica

Intra- and inter-provider referral

Intravitreal injectable anti-VEGF agents for eye disease

Invasive coronary angiography for patients with low risk, stable chest pain

Invitro fertilisation (IVF) and intracytlopasmic sperm injection (ICSI)

iPort Advance®

Irrigation of the external auditory canal (not routinely commissioned)

Kidney stones - surgical removal of kidney stones

Laser or intense pulsed light (IPL) treatment

Lumbar discectomy

Lumbar radiofrequency facet joint denervation

Male gynaecomastia reduction surgery

Microsuction of the external auditory canal

Mitomycin C bladder instillation following trans-urethral resection of bladder tumour (TURBT)

Needle biopsy of prostate in patients with suspected prostate cancer

Oculoplastic eye surgery

Open, wide bore and upright magnetic resonance imaging (MRI)

Percutaneous tibial nerve stimulation (PTNS) for faecal incontinence

Percutaneous tibial nerve stimulation (PTNS) for urinary incontinence

Pinnaplasty (Otoplasty)

Planned follow-up care after private surgery in the UK or abroad (not routinely commissioned)

Pre-operative chest x-ray

Pre-operative electrocardiogram (ECG)

Prescribing policy for primary care providers

Referral to specialist chronic fatigue services

Repeat ordering schemes ('managed repeats') for GP practices

Resperate© (Intercure Ltd) (not routinely commissioned)

Resurfacing procedures: dermabrasion, chemical peels and laser treatment (not routinely comissioned)

Reversal of sterilisation (not routinely commissioned)

Rhinosinusitis - surgical intervention for chronic rhinosinusitis

Sacral nerve stimulation (neuromodulation) for idiopathic chronic urinary retention in men and women

Sacral nerve stimulation (SNS) – faecal retention (not routinely commissioned)

Scar revision and skin resurfacing

Snoring surgery (in the absence of obstructive sleep apnoea)

Spinal epidural injections

Spinal fusion surgery

Surgery for nasal deformity (including rhinoplasty, septorhinoplasty and septoplasty)

Surgical intervention for bladder outflow obstruction (BOO)

Surveillance colonoscopy for patients after colorectal cancer resection or after colonic polypectomy

Surveillance colonoscopy for patients with hereditary increased risk of colorectal cancer

Tenotomy for curly toes in children

Thigh and buttock lift (not routinely commissioned)

Tier 3 weight management services

Tonsillectomy for recurrent tonsillitis

Trigger finger release in adults

Trigger point injections

Ultrasound guided injection (USGI) of soft tissue or joints

Vaginoplasty, labiaplasty and hymenorrhaphy

Varicose vein interventions

Vertebral augmentation for painful osteoporotic vertebral fractures

Wireless or implantable functional electrical stimulation (FES)

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