The Impact of Commissioning for Rhinosinusitis in England

Archana Soni-Jaiswal, Carl Philpott, Claire Hopkins

Research output: Contribution to journalArticlepeer-review

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Abstract

Objectives: To assess the compliance of clinical commissioning groups (CCG) in
England with the ENT-UK Rhinosinusitis commissioning guide produced in collaboration with the Royal College of Surgeons England and the National Institute of Clinical Excellence. We also aimed to assess the ease of accessibility of data from CCG’s.
Design:Audit of compliance of English CCG’s with the ENT-UK rhinosinusitis
commissioning guide.
Setting: CCG’s in England
Participants: 58 of the 221 CCG’s in England were included, chosen because they were the first CCG’s authorised by NHS England or alternately, the CCG’s forecast to have a deficit in their first year of operation.Their websites were reviewed; when information was not easily accessibly, a freedom of information request was submitted to the relevant CCG.
Main outcome measures: Compliance with commissioning guidelines for
rhinosinusitis.
Results: 13% of CCG’s had restrictive referral criteria in place,largely unrelated to
published evidence-based guidance. The routine use of multiple courses of oral steroids, prescription of antibiotics, CT scanningwithin primary care, and delaying referral for a year, prior to referral to a specialist were recommended against published advice.
Conclusions: Restricting access to surgerymay contribute to poorer outcomes and a decrease in the patient’s quality of life. This is against the NHS constitution and open to legal challenge. We encourage all ENT surgeons to review policies of their local CCG and engage with commissioners to ensure that their patients have evidence-based care.
Original languageEnglish
Pages (from-to)639–645
JournalClinical Otolaryngology
Volume40
Issue number6
Early online date8 Apr 2015
DOIs
Publication statusPublished - Dec 2015

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