I’ve requested or heard of requests for cosmetics procedures but not heard reference to a cosmetics policy – why is that?
All of the Clinical Commissioning Groups in Lancashire currently have a number of clinical policies that deal with cosmetic issues or with the patients’ appearance, such as the policy for hair depilation, the policy for cosmetic facial procedures and the policy for tattoo removal. In undertaking the process to review these cosmetics procedures the opportunity has been taken to consolidate these various policies, with a range of titles, into one overarching cosmetics policy. Procedures that you may have referred to previously will now come under the one policy but they will all have in common the fact that they are cosmetic and are concerned with the appearance of individuals.
Will someone with serious burns or other injuries come under the new draft cosmetics policy?
Cosmetic or what may be considered as cosmetic procedures in relation to trauma, such as serious burns and other accidents, and cancer treatments, do not come under this policy. These procedures are routinely funded as part of the cancer and trauma treatments provided through hospital contracts and are therefore, not covered by this policy.
Does the cosmetics policy cover issues relating to transgender?
Appearance changes requested or desired in order to align a patient’s appearance with that of their chosen gender are covered by the draft cosmetics policy. However, cosmetic procedures for people undergoing gender reassignment where those procedures fall within the commissioning remit of NHS England are not covered by this policy, which relates only to the responsibilities of Clinical Commissioning Groups.
What changes have been made to the draft updated and revised policy on the commissioning of cosmetic procedures?
The existing policies vary between each CCG in Lancashire and South Cumbria and the changes made are also varied as a consequence. The main change that is common to all the CCGs is that any cosmetics treatments or procedures that were mainly concerned with changing the appearance and had little or no other purpose will now not be routinely funded. Some procedures, such as tattoo removal, were not funded by any CCG area anyway, but some procedures, such as breast augmentation, breast asymmetry and abdominoplasty (tummy tuck) were provided in some areas but these will no longer be routinely provided under the revised draft policy.
You funded some of these cosmetic procedures before – why can’t this continue? What has changed?
Yes, some cosmetic procedures with the main purpose of changing your appearance were funded previously, in certain circumstances. Some of these procedures or treatments will continue to be available if they relate to a medical or functional problem for the person concerned (see below).
However, to continue to fund procedures that are only or mainly concerned with appearance cannot be maintained in the current financial environment. Demand for services that are more clearly concerned with preserving life or preventing grave health consequences continues to rise and the local NHS simply cannot afford to support cosmetic procedures to the detriment of these higher priority services. It is the practical realisation of this that has changed for the CCGs across Lancashire and South Cumbria.
What is meant by medical or functional problems, as they relate to cosmetic procedures?
Some medical issues, such an intertrigo, where folds of excess skin become infected, may require a cosmetic procedure to treat the problem. Similarly, excess folds of skin may interfere significantly with mobility or with cleanliness, or, if around the eyes, interfere with sight, and these are functional problems that a cosmetic treatment or procedure may resolve. These types of issues will continue to be funded where they meet the criteria outlined in the policy.
If you do not meet the criteria for a treatment but your doctor believes you would benefit from the treatment, an Individual Funding Request can be put forward.
I gave feedback about a revised cosmetics policy last year. I heard nothing more. What is the link between that policy and the new draft that is on the website now?
Some people may recall seeing or providing feedback on a revised draft cosmetics policy last year. That policy was never adopted. This is the same policy with further revisions and amendments.
Following the engagement process with patients and members of the public all the Clinical Commissioning Groups realised they could not continue with the draft cosmetics procedure policy as it stood at that time. It was felt that the policy needed further work. A significant element of this work was around what the CCGs could afford to fund in relation to cosmetics procedures going forward.
The latest draft policy is the original harmonised draft policy from last year with broad changes and revisions. As a result of this process the current, smaller cosmetics policies (there are several of these covering different procedures) remain the existing, live policies around cosmetic procedures. They will remain in force until the revised draft policy on cosmetic procedures is adopted by the CCG.
A firm date for the adoption of this policy has not been determined as there are still a number of processes to go through before the CCGs can approve and adopt this policy. Public engagement will take place over a 12 week period following which there may be changes made to the policy. The policy will then need to be considered by the Commissioning Policy Development and Implementation Working Group, which is overseeing the policy review process, before final consideration by the CCGs. It is anticipated however, that the policy should be in place by April 2018.