Smith Kirsty M, Haeney James A
Plastic and Reconstructive Surgery Department, Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom.
JPRAS Open. 2019 Nov 5;23:32-36. doi: 10.1016/j.jpra.2019.10.005. eCollection 2020 Mar.
In 2013 Clinical Commissioning Groups (CCGs) were created and became responsible for the planning and commissioning of health care services in their area. The Royal College of Surgeons and the British Association of Plastic, Reconstructive and Aesthetic Surgeons created guideline for the CCGs in 2013 for the surgical treatment of prominent ears. By looking at each of the CCGs' websites, we aim to review their equity and how well they adhere to standards to determine whether there is a regional variation for funding of this procedure. We found that 47% of the CCGs will fund this procedure only on an exceptionality basis, compared to 26% who had set criteria and would allow funding if these criteria were met. There was significant variation in the age at which funding would be considered with some CCGs allowing funding from 5 years of age and others not providing it until as old as 11 years. Only 11 policies made any reference to cartilage moulding and only 3 mentioned funding to allow correct fitting of hearing aids. Unfortunately, despite recommendations from the Royal College of Surgeons and the British Association of Plastic and Reconstructive Surgery, there is still variation in funding criteria between CCGs for correction of prominent ear surgery. This may result in patients being treated differently depending on their postcode. We would urge commissioners to apply more consistent and uniform guidelines for the funding of surgical correction of prominent ears.
2013年，临床委托小组（CCGs）成立，并负责其所在地区医疗服务的规划和委托。皇家外科医学院和英国整形、重建与美容外科协会在2013年为CCGs制定了招风耳手术治疗指南。通过查看每个CCGs的网站，我们旨在审查其公平性以及它们对标准的遵守程度，以确定该手术的资金是否存在地区差异。我们发现，47%的CCGs仅在特殊情况下才会为该手术提供资金，相比之下，26%的CCGs制定了标准，若符合这些标准则允许提供资金。在考虑提供资金的年龄方面存在显著差异，一些CCGs允许从5岁起提供资金，而另一些则直到11岁才提供。只有11项政策提及了软骨塑形，只有3项提到为正确佩戴助听器提供资金。不幸的是，尽管皇家外科医学院和英国整形与重建外科协会提出了建议，但CCGs在招风耳矫正手术的资金标准方面仍存在差异。这可能导致患者因所在邮编不同而受到不同的治疗。我们敦促委托方为招风耳手术矫正的资金提供更一致和统一的指导方针。
