We are looking at how we spend our money in the NHS in West Yorkshire and what treatments we pay for. Up to now, some of these choices have been different depending on where you live.
We are reviewing our commissioning policies to make sure everyone gets the same access to treatments, wherever they live in West Yorkshire. This will also make sure all our policies are in line with the latest expert advice. Commissioning policies are documents that contain information about treatments, and who can have those treatments paid for by the NHS. We are recommending changes to some of these policies to make them the same across West Yorkshire.
Some people living in West Yorkshire could be affected by these changes. See below for an outline of our recommendations for those policies and the involvement that took place. For more details about the policies and the recommendations please see this page Treatments paid for by the NHS.
Update 28 February 2024 - Changes to gluten-free prescribing
The ICB Transformation Committee met on 27 February 2024 to review new information and decide whether to continue providing gluten-free products on prescription. Please see the full update on this page Treatments paid for by the NHS.
Background
Gluten-free prescribing was stopped in Bradford District and Craven in 2016, and in Kirklees and Wakefield District in 2017. However, in Calderdale and Leeds, limited gluten-free products are currently still prescribed. Our recommendation is to stop gluten-free prescribing in Calderdale and Leeds to bring them in line with other areas in West Yorkshire. This does not include prescribing for phenylketonuria (PKU) which is a separate policy.
Involvement - carried out in two stages
The first stage (25 May to 21 June 2023) was aimed at patients in Calderdale and Leeds who are prescribed gluten-free products. Patients were invited by their GP practices to have their say on how the recommendation would affect them by completing a short survey. Of the 294 patients who completed the survey, 262 said that stopping prescribing gluten-free products would have an impact on them or their household. The key themes were:
- cost of gluten-free products would be the most significant impact
- people with coeliac disease have to eat gluten-free food to stay healthy
- people with coeliac disease should receive the same level of support as other conditions
- products available in supermarkets were not comparable to those on prescription which contain replacement vitamins and minerals
- products available on prescription are a higher quality and taste better
- financial impact could lead to people not following a gluten-free diet which could result in serious health conditions that would impact on the NHS
- children with coeliac disease use prescription bread to take sandwiches to school.
This report Gluten-free prescribing involvement and equality report (June 2023) outlines what these patients told us.
The second stage of involvement (13 July to 9 August 2023) was open to anyone is West Yorkshire. Of the 86 respondents to the stage 2 survey, 83 people shared their views on the recommendation for gluten-free prescribing. Most people said they do not want gluten-free prescribing in Calderdale and Leeds to be stopped. The key themes were:
- people with coeliac disease must follow a gluten-free diet which is difficult due to the cost
- we must have consistent policies across West Yorkshire
- problems with availability of gluten-free products in supermarkets and shops
- the NHS needs to make the best use of its limited resources
- quality of products in supermarkets and shops is not as good as those provided on prescription.
This report Treatments paid for by the NHS involvement report (September 2023) outlines what these people told us.
On 9 August 2023 (during stage 2 of involvement) Coeliac UK submitted this response to the involvement on the future of gluten-free prescribing which is included in the stage 2 report.
Background
The BMI requirement for aesthetic abdominal procedures, body contouring, breast lift, breast reduction for male gynaecomastia, breast surgery and liposuction varies across West Yorkshire. The ICB recommendation is to set the BMI requirement to 27 or below across all places. Achieving a BMI of 27 or below before surgery has a positive effect on different anaesthetic risks, wound healing rates, rates of postoperative infection and the ability for people to get mobile after surgery.
Involvement
Involvement on our recommendation to set the BMI to 27 or below for these types of cosmetic surgery took place from 13 July to 9 August 2023. Of the 86 respondents to the survey, 38 people shared their views on this recommendation and the majority agreed with it. Most also agreed that having consistency across West Yorkshire is important, as is following clinical evidence. Some people commented that such procedures should be considered on a case-by-case basis.
This report Treatments paid for by the NHS involvement report (September 2023) outlines what these people told us.
Next steps
All feedback is being considered by system partners including the senior management teams at all five West Yorkshire places and the ICB policy harmonisation working group. All system partners will be brought together to discuss the findings of the involvement.The ICB Transformation Committee will consider all the information provided before its next meeting (expected to be towards the end of October 2023) when a decision on the recommendation will be made.
Background
The age range for access to ear correction surgery on the NHS varies across West Yorkshire. The ICB recommendation is for it to be available for children and young people from age 5 to 18. This would align the policy with other treatments for those aged 18 and under, and with NHS guidance.
Involvement
Involvement on our recommendation to set the age range as 5 to 18 for ear correction surgery to 5 took place from 13 July to 9 August 2023. Of the 86 respondents to the survey, 38 people shared their views on this recommendation and the majority agreed with it.
This report Treatments paid for by the NHS involvement report (September 2023) outlines what these people told us.
Next steps
All feedback is being considered by system partners including the senior management teams at all five West Yorkshire places and the ICB policy harmonisation working group. All system partners will be brought together to discuss the findings of the involvement. The ICB Transformation Committee will consider all the information provided before its next meeting (expected to be towards the end of October 2023) when a decision on the recommendation will be made.