Bunion Surgery ‘is Low Priority’

Aesthetics Hub | 8 Feb 2013

Health chiefs have scrapped bunion removal surgery in all but the most crippling cases. Bosses at NHS Oxfordshire said many people with bunions do not need surgery as they do not have symptoms and the procedure can lead to side effects, although the policy is seemingly at odds with NHS guidance to the public.

The Society of Chiropodists and Podiatrists last night hit out at the cut in treatment.

NHS Oxfordshire, the county’s primary care trust (PCT), said bunion removal would be a low priority “regardless of cosmetic appearance” from January and denied it was trying to save cash. Those with painful symptoms where non-surgical methods like specialist footwear and painkillers have failed will get funding. But they would also need to show “severe deformity” or pain causing “significant functional impairment”.

The authority said a “considerable number of people” have no symptoms and surgery risks pain, stiffness, infection, swelling and blood clots.

From April 2009 to April 2011, some 39 county people had surgery costing the NHS £66,000.

Asked if people will need to wait for their bunion to be painful enough for surgery, spokesman Ruth Atkins said: “The policy sets a threshold for surgery so that those who really need it and will benefit the most will still get it.” NHS guidance for the public says surgery is the “only” way to correct a bunion, adding: “Bunions usually get worse over time, so a bunion that is left untreated is likely to get bigger and become more painful.”

It comes as the PCT – which spends about £1bn a year – warns it will not hit a £6.2m savings target this year and will need a £6.9m bailout by regional NHS chiefs. Dr Peter Skolar, chairman of the Oxfordshire Joint Health Overview & Scrutiny Committee, said: If money was no object, I don’t suppose they’d be looking at it.”

Nita Parmar, spokesman for the trade body, said: “This is a shocking decision that will have a detrimental impact on patients.

“Painful feet are not normal and all patients with foot pathology should be as entitled to NHS care as those with painful hips, hands and knees.”

And Age UK Oxfordshire’s Rachelle Kennedy said: “Bunions are a significant health issue that can cause many older people to lose their mobility – a crucial factor in quality of life.”

“Problems in keeping mobile will not only impact on independent living, it can cause further health issues, costing the health service more money.”

But private Oxford chiropodist Elizabeth Humble-Thomas, who said about 70 per cent of women have a bunion of some sort, backed the NHS decision. The George Street practitioner said: “I very rarely come across anybody who wants it done for cosmetic reasons.

“I wouldn’t recommend it as it is such a nasty operation and they are likely to end up with a poor result.”

Clare Carr, podiatry clinical services manager for Shuropody, which has a branch in New Inn Hall Street, Oxford, also backed the NHS. Those who cannot get funding face using the costly private sector, with Headington’s Manor Hospital charging £3,135 for one foot and £4,620 for both.

Source: Oxfordmail