Hundreds of breast cancer patients have been denied “life-changing” reconstructive surgery due to NHS restrictions, said a report.

 

The Breast Cancer Now findings show nearly a quarter of local NHS commissioning groups had established policies to restrict reconstruction services for non-clinical reasons. 

 

The consequences of the restrictions include women being limited to the number of surgeries they were allowed, and a window of time being allotted for when they could have the surgery, said the charity.

 

 

These clauses meant some patients are ineligible for surgery to make sure both breasts are symmetrical, and patients are being rushed into potentially life-changing decisions.

 

Speaking about the policies, Baroness Delyth Morgan, chief executive of the charity, said it was “totally unacceptable.”

 

“Reconstructive surgery has profound benefits for those that choose it, helping give many their confidence and their lives back after breast cancer.

 

These arbitrary restrictions in some areas of the country, therefore, represent a backward step in treatment and are absolutely not in the best interests of patients," she said. 

 

“The reasons for these restrictions remain unclear, but with the NHS facing unprecedented pressures, their introduction despite clear clinical advice begs the question whether they are being driven by a desire to reduce costs,” she added.

 

 

It is estimated that around 11,500 of the 42,000 women diagnosed with breast cancer each year in England undergo a mastectomy.

 

From those figures, around 21 percent of these patients opt to have immediate breast reconstruction, and an additional ten percent are having delayed reconstruction.

 

The charity gathered evidence of the policies through from Freedom of Information (FOI) requests.

 

It shows that 47 out of 208 Clinical Commissioning Groups (CCGs) in England have established policies to restrict reconstruction services for non-clinical reasons.

 

 

A further nine CCGs have draft policies or informal restrictions in place.

 

According to the report, the policies directly contradict recent clinical advice issued by NHS England’s Breast Cancer Clinical Expert Group in 2017.

 

The group said: “patients make decisions at very different speeds so delayed reconstruction or further operative procedures to optimise symmetry should be available without time restrictions.”

 

 

Mr Joe O'Donoghue, Member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons, spoke out against the restrictions.

 

"It is unacceptable for some women to not be given access to essential reconstructive or balancing surgery purely because of where they live. We know that this surgery is a vital part of breast cancer treatment, recognised by the National Institute for Health and Care Excellence and internationally as beneficial to women’s psychological recovery and wellbeing.



BAPRAS calls on all Clinical Commissioning Groups to implement the new guidelines and ensure that all women access the appropriate care they need, when they need it.”

 

The NHS has yet to comment on the findings. 

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