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Uncomplicated varicose vein surgery in the UK--a postcode lottery?
M K Nasr1, J S Budd, M Horrocks
1Department of Vascular Surgery, Royal United Hospital, Bath, UK. mohamed.nasr@btinternet.com
Annals of the Royal College of Surgeons of England
|September 4, 2008
Summary
Surgical treatment for varicose veins varies significantly across the UK due to local funding restrictions. Many patients are denied necessary surgery for symptomatic uncomplicated varicose veins based on their geographical location.
Area of Science:
- Vascular Surgery
- Health Economics
- Public Health Policy
Background:
- Uncomplicated varicose vein surgery offers significant quality of life improvements over conservative treatment at a low cost.
- Substantial variations exist in varicose vein treatment indications across the UK, largely influenced by Primary Care Trust (PCT) financial constraints.
Purpose of the Study:
- To quantify the variations in varicose vein treatment indications across the UK.
- To investigate the impact of local Primary Care Trust (PCT) restrictions on surgical treatment for varicose veins.
Main Methods:
- An email questionnaire was distributed to 245 surgical members of the Vascular Society of Great Britain and Ireland.
- The survey focused on identifying PCT-imposed restrictions on varicose vein treatment.
Main Results:
- A 44% response rate (109 surgeons) was achieved.
- 64% of responding surgeons reported facing restrictions from their local PCTs regarding varicose vein treatment.
- Despite restrictions, 62% of surgeons under these limitations still provided surgery for symptomatic uncomplicated varicose veins, with regional variations in restrictions ranging from 0% to 100%.
Conclusions:
- Patient access to surgical treatment for symptomatic uncomplicated varicose veins is inequitably determined by geographical location within the UK.
- This geographical disparity exists irrespective of the severity of patient symptoms.
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