The Professor Harold Ellis Medical Student Prize for Surgery 2012

In austere financial times, which procedures should be rationed and who should decide?
Maral Rouhani
5th year Medical student University of Cambridge

The Nicholson Challenge

NHS Trusts will have to deliver between 15 billion and 20 billion in efficiency savings over three years from 2011 to 2014.1

1. David Nicholson speech to the Healthcare Financial Management Association, reported in the Daily Telegraph, 2009.

Procedures of Limited Clinical Value

Cataract removal Joint replacement

Tonsillectomy

1. Discrimination 2. Debt

3. Delays

http://www.gponline.com/News/article/1136671/Exclusive-90-PCTs-rationing-care/

Do you have an asymptomatic inguinal hernia in Oxfordshire?

NICE Watch and Wait2

Need gastric banding/bypass in South Staffordshire?

NICE Only BMI over 503

2. http://www.oxfordshirepct.nhs.uk/professional-resources/priority-setting/lavender-statements/documents/LS68a_ElectiveSurgeryInguinalHernia.pdf 3. http://www.southstaffordshirepct.nhs.uk/policies/Commissioning/PolicyNo10BariatricSurgery.pdf

1. Discrimination standardised evidence 2. Debt long-term cost-effectiveness

3. Delays patient care

Oh dear, were in a bit of a pickle.

I dont know what Im doing!

AUDIT

Save!

Reduce waste Improve efficiency

early recovery programs theatre change-over faster PAC

PROCEDURES

these In austere financial times, which procedures should be rationed? tailored

Thank you.