NHS Service Changes in Hertfordshire

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A joint committee made up of representatives from both Herts Clinical Commissioning Groups (CCGs) have announced a number of decisions about NHS services in the county.

These decisions follow a 10 week extensive public consultation;  Let’s Talk, on a series of proposals designed to make the best use of the money and resources available to the local NHS and encourage people to live healthier lives, avoiding preventable illnesses. All proposals were debated in full and members of the public had the opportunity to make representations in front of the committee.

The changes are:

  • Morbidly obese patients with a BMI over 40 will be required to reduce their weight by at least 15% before accessing nonurgent surgery and for those with a BMI of over 30, we are looking for a reduction of 10%. These criteria will apply unless waiting for surgery would be more harmful.
  • Smokers will be required to quit smoking before being referred for nonurgent surgery, unless waiting for surgery would be more harmful for them.
  • Gluten- free food will no longer be available on prescription, with the exception of those patients with learning disabilities or where there are welfare concerns.
  • In future, people wanting a prescription for medicines, products and food items that are available to buy from pharmacies, supermarkets or shops for short-term conditions will need to purchase them directly, except in exceptional circumstances.
  • Female sterilisation will only be funded in exceptional circumstances, which would be assessed on a casebycase basis if alternative forms of longacting contraception are unsuitable.
  • IVF and other specialist fertility treatments will no longer be funded, except in exceptional circumstances.  This decision will be reviewed after one year, in the light of the financial position Herts Valleys finds itself in at that time.

A proposal to stop funding for vasectomies was rejected on the basis that this would not be cost-effective when the long-term cost of contraceptive services is taken into account.

During an extensive public engagement campaign - which included big public meetings, drop-in discussion events, press and social media – thousands of online and postal responses were received from members of the public, special interest groups, clinicians, local wellbeing groups and providers of services. The vast majority of the proposals received considerable public support.  

Dr Nicolas Small, Chair of Herts Valleys CCG said:

“None of these decisions have been taken lightly, but people understand that the NHS faces major challenges and must adapt to meet them.  There is wide public backing for most of the changes that have been agreed today – even from people who told us that they would be directly affected. 

“As we plan the implementation of today’s decisions over the months ahead, we will make sure that everyone who needs to make lifestyle changes, including those who need to lose weight or quit smoking, gets the information and support they need to succeed.

“Although we are asking people to take more responsibility for some aspects of their healthcare where possible, we won’t be withdrawing any support from people who are not able to do this.  GPs will still make decisions based on the individual needs of their patients, and will be able to refer individual cases to a specialist decision-making panel if their patient faces exceptional clinical circumstances.

“Proposals on IVF services in particular generated strong feelings and it was an especially difficult decision. We have listened to the views of local people and I am pleased that we decided to review today’s decision in 12 months’ time in the context of our future financial position.

The changes will be implemented over the coming weeks and months, along with a public information campaign about the changes.

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