A total of 17 procedures have been considered ineffective treatments by NHS England, because they may be risky and replaced with improved results by physiotherapy, injections, or changes in diet. That is a conservative attitude, meaning that people may obtain the same result without undergoing more invasise procedures. These are mostly surgical and invasive procedures, many orthopedic. They have been submitted to scientific and quality analysis based on evidence, and this is the administrative result, supported by health profession groups.

The English NHS is one of the best health systems in the world from any point of view, including the fact the the population it serves is incredibly diverse, from the racial, economic and social points of view. It covers fully the needs of tens of millions of people. It has recently considered homeopathy one of many ineffective treatments it wil not allow to run under its auspices any longer. The procedures are:

Surgery for snoring, dilatation and curettage for heavy menstrual bleeding, knee arthroscopies for osteoarthritis,  injections for non-specific back pain, breast reduction, removal of benign skin lesions, grommets for Glue Ear, tonsillectomy for sore throats, haemorrhoid surgery, hysterectomy for heavy menstrual bleeding, chalazia (lesions on eyelids) removal, arthroscopic compression for subacromial shoulder pain, carpal tunnel syndrome release, Dupuytren’s contracture release for tightening of fingers, ganglion excision – removal of noncancerous lumps on the wrist or hand, trigger finger release, varicose vein surgery.

From now on people will have these procedures by special consideration of each case, and not on a routine base. They may also pay and have the procedures privately. In severe cases the procedures may be carried out under the auspices of the NHS, but only after case by case consideration. In general, these procedures have been considered ineffective treatments by evaluation of evidence.

Dr Paulo Bittencourt


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