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Related Experiment Videos

Bilateral breast reduction surgery in England: a postcode lottery.

William M Wraight1, Sherilyn K L Tay, Charles Nduka

  • 1Department of Plastic Surgery, Queen Victoria Hospital, Holtye Road, East Grinstead, West Sussex RH19 3DZ, UK. will.wraight@doctors.org.uk

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|May 1, 2007
PubMed
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Funding criteria for bilateral breast reduction (BBR) vary significantly across UK health trusts, despite national guidelines. This leads to unequal access to the beneficial surgical procedure, creating a healthcare postcode lottery.

Area of Science:

  • Plastic Surgery
  • Health Services Research

Background:

  • Bilateral breast reduction (BBR) offers proven benefits but is often deemed cosmetic and subject to rationing.
  • National guidelines exist, but local implementation by Primary Care Trusts leads to variations.

Purpose of the Study:

  • To survey and analyze the funding criteria for BBR across all English Primary Care Trusts.
  • To identify variations in local implementation of national guidelines for BBR.

Main Methods:

  • A survey was distributed to all 303 Trusts in England regarding their BBR funding criteria.
  • A response rate of 81% (245 Trusts) was achieved.

Main Results:

  • Only 11 Trusts accurately followed national NHS guidelines.

Related Experiment Videos

  • Significant variations in criteria were observed, including maximum BMI (198 trusts), accepted indications like musculoskeletal symptoms (187) and intertrigo (117), and bra requirements (31).
  • Many Trusts imposed additional restrictive criteria beyond national guidelines.

    • Conclusions:

    • Considerable variation in local funding criteria for BBR leads to inequalities in provision, exemplifying the UK's healthcare 'postcode lottery'.
    • The reconfiguration of Trusts presents an opportunity to rationalize BBR provision.
    • Findings and guidelines will be distributed to new Trusts and NICE to promote standardization.