£22m spent on restricted procedures in one year by trusts

Health trusts in Northern Ireland spent almost £22 million in a single year on restricted procedures that should only be carried out in very specific circumstances, according to the auditor general.

Dorinnia Carville said around 12,000 operations, including tummy tucks and tonsillectomies, were carried out in 2023-2024 without any guarantee they were in line with government policy.

Ms Carville described the lack of oversight from the Department of Health and trusts as “very disappointing”.

The Department of Health and the five health trusts have acknowledged the concerns raised in the Audit Office report and accepted that monitoring arrangements need to be strengthened.

Health trusts must adhere to the Efficient Use of Resources (EUR) policy which restricts 29 medical procedures, six of which are banned at all.

The Audit Office report reveals that 40 restricted procedures were carried out every day during this year.

Other restricted procedures include liposuction, breast reduction, breast implant removal, carpal tunnel and tattoo removal.

Around £6 million was spent in a single year removing patients’ tonsils.

Procedures such as repairing split earlobes, repairing simple snoring, and reversing male and female sterilization are not permitted.

The Auditor General found that the EUR policy “did not achieve good value for money”.

She said: “Trusts do not have arrangements in place to check that medical staff are following the policy. »

“As our health services face increased demands and significant financial pressures, measures put in place to ensure resources are used efficiently are essential.

“However, these measures can only be successful if they are properly implemented and monitored.”

Although some of the thousands of procedures carried out may have been authorized under the policy, the report reveals health trusts have no arrangements in place to check this.

No such assurance was provided by the trusts in 2023-24, and none was requested by the department, the auditor general said.

The report recommends that trusts put arrangements in place to monitor and comply with the rules, and that the Department of Health ensures that they do so.

It also asks the ministry to review the rules policy every two years.

The Department of Health said it was committed to working collaboratively over the next 12 months to implement the recommendations.

“It must be emphasized that the EUR commissioning position is there to guide clinicians who must continue to exercise their professional judgment to provide appropriate and timely care,” a spokesperson added.

“While there is a responsibility to consider the position, other factors must also be considered, including patient safety.”