Thursday, 25 July 2013

Will NHS and Private Insurers drop varicose veins after NICE guidelines?

Will the NHS and private medical insurance companies buckle under the new NICE guidelines for varicose veins?

Yesterday, almost hidden away under the immense news coverage of the Royal birth, the NICE guidelines for varicose veins were published. Their recommendations were revolutionary and they could have a major impact on the National Health Service and private medical insurance in the UK - but thanks to Prince George, what should have caused a storm of interest has passed with barely a passing glance.

Article in Huffington Post - 24th July 2013

For the first time, the National Institute of Health and Care Excellence (NICE) has stated that anyone with varicose veins and symptoms should be referred to a special vascular service. At the present time, most people going to their general practitioners with varicose veins get turned away and told they are "only cosmetic". With somewhere in the region of 20% of the adult population having visible varicose veins, how will the NHS cope if all of these people quote the new NICE guidelines and demand referral?

Clearly there will not be enough money in the system for these people to have treatment.

The private medical insurance companies do not see their role as propping up a failing NHS - and are highly unlikely to pay for patients to have varicose vein treatments if the NHS can't afford to provide them.

Furthermore, both the NHS and private medical insurance companies have used support stockings as a way of procrastination. Both have avoided referring patients with varicose veins for treatment by insisting they wear support stockings for a variable amount of time. Once again the NICE guidelines clearly state there is no evidence for the use of support stockings as a "treatment" of varicose veins and as such should not be used to delay a referral.

Rather tellingly, on Radio 4 a couple of weeks ago, a politician was quoted as saying that just because a procedure or treatment shows an improvement in quality-of-life for patients, it doesn't mean to say that the NHS can afford to provide it.

Personally, I think that the fallout from these NICE guidelines for varicose veins could have massive ramifications for healthcare provision in the country. It could be the first time that the government and NHS are honest enough to say that not all healthcare that has a positive medical advantage of patients can be afforded on the NHS and this will probably spark the private medical insurance companies to do the same.

The speed of this will depend upon how quickly the public with varicose veins and venous disease realise the impact of what NICE has said and start insisting on referrals and treatment. It may be fortunate for those in the NHS management and private health insurance companies that the birth of Prince George has diverted enough attention to slow the message getting out to the public.

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