NHS treatments blacklist  The NHS treatments blacklist is an informal name for a list of medicines and procedures which will not be funded by public money except in exceptional cases. These include but are not limited to procedures which the National Institute for Health and Care Excellence (NICE) has ruled of limited effectiveness and particular brand name medicines. In 2017 there was a proposal for 3,200 over the counter (OTC) drugs to be restricted and 18 procedures to be added to the list. This generated some controversy amongst doctors with some arguing that OTC should be blacklisted instead, and others believing the move didn't take into account individual patient needs. The NHS has produced lists of procedures of limited clinical effectiveness for many years, advising that they should not be carried out except in exceptional cases. Since the establishment of NICE in 1999 there has been a move to more robust processes, but such decisions always generate controversy. These lists are now decided by clinical commissioning groups in England, but rules differ in Wales, Scotland and Northern Ireland. Restrictions on one kind of treatment for a condition may lead to patients getting different, and possibly more expensive treatment. Treatments for back pain, tonsillectomy, in vitro fertilisation, varicose veins commonly appear on these lists. Research by the Medical Technology Group reported in 2019 showed that many clinical commissioning groups were restricting access to basic elective surgeries and treatments in various ways, including imposing body mass index thresholds for hip and knee replacements, or visual acuity limits for cataract surgery. In April 2019 NHS England issued guidance to NHS Trusts on the basis that the evidence shows that in most cases the benefits of these procedures don't justify the risk and opportunity cost involved. Four procedures in Category 1 are only available in "exceptional circumstances" :  For 13 procedures in Category 2 patients must "meet agreed criteria":  Warrington & Halton Hospitals NHS Foundation Trust introduced what they called the My Choice system in 2013, which enabled people to pay themselves for procedures the NHS would not provide for patients who had been denied varicose vein procedures. In 2019 it was expanded. The price list includes £8,500 for revision of knee replacement surgery, £7,000 for a hip replacement or hip resurfacing, and £2,000 for circumcision. Warrington withdrew their advertisement after an outcry, but in July 2019 it was reported that other trusts with private patient units were still offering these procedures for people who would pay. NHS England sent out a message saying they "expect NHS trusts to be evidence-led in everything they do…