Some surgical procedures and treatments may not help patients in all circumstances. They can be painful and result in complications or harm that may outweigh any benefits. Sometimes, a safer, simpler alternative may be available. Therefore, surgical procedures should only be offered to patients who really need them.
As a result there are some surgical procedures and treatments that NHS commissioners do not normally pay for, or only pay for in specific circumstances.
NHS organisations across the country have developed criteria for accessing many common tests, treatments and procedures, to make sure that:
- patients receive the right treatment, at the right time
- treatments with no, or very limited, evidence of benefits to health are not used
In Kent and Medway, these criteria are listed in a document called the Referral and Treatment Criteria (RaTC) which:
- contains policies on around 140 tests, treatments and procedures.
- explains when each of these treatments can and can’t be used by clinicians to treat Kent and Medway patients.
- helps clinicians identify patients most likely to benefit from particular treatments.
While the quality of care given to patients is the most important factor for these policies, they will also help to free up time and resources that can be reinvested in patient care.
Policies included have been developed through a rigorous review process involving doctors, pharmacists, a member of the public and commissioners.
These policies help make sure the NHS offers treatments, based on the latest available evidence, fairly and consistently across Kent and Medway.
The NHS is committed to providing the most effective, fair and sustainable use of finite resources. NHS resources should be focused on treatments that have been proven to be effective and appropriate.
Making sure that treatment and care is focused where it can make the biggest difference is a key part of getting the best use out of NHS resources. This is a key challenge for all NHS organisations.
Exceptions to the criteria
There is no blanket ban on any of the treatments covered. If you do not meet the eligibility criteria for a particular treatment or the treatment is not normally funded, your doctor can make an individual funding request (IFR) if they think that you meet the criteria for ‘exceptionality’ or ‘rarity’.
For more information on individual funding requests, visit our individual funding requests page.