Denial of NHS treatment for immuno-suppressed child who can't use over the counter self-care

A mother hascontacted us in response to a CK999 blog post about Lincolnshire Sustainability and Transformation Partnership’s new “financial framework and contracting model“. This aims to

“reduce demand and cost [for] Diabetes, Frailty, Urgent and Emergency Care, elective care, stroke rehabilitation and Mental Health”

This new financial framework and contracting model is central to the new USA-style Accountable/Integrated Care Systems that the government and its quango NHS England is dismantling the NHS into.

When self-care means denial of NHS care AND of private treatment

A key principle of these cost-cutting, care-denying Accountable/Integrated Care Systems is patient self – care. We are constantly being told the Accountable Care Systems are empowering us to self-care instead of wasting NHS money.

This little girl’s experience tells us what happens when self-care isn’t possible. NHS care is denied – private care too, because of her underlying medical conditions. She is left to suffer.

The mother told us,

I had dealings with [denial of elective care] with my 9 year old daughter… she has a huge verruca on her foot, she has chronic acute urticaria (has epi pens) & a rare immune disorder.

The over the counter treatments caused a allergic reaction so we couldn’t use them, the damage caused by her urticaria caused scar tissue to build up… the verruca is so big she can’t put her shoe on…

The NHS has stopped any treatment for warts/verrucas or anything classed as ‘cosmetic’ to do with the feet, to ‘cut costs’…

No private company will touch her due to her medical conditions

The mother continued,

I tried to go private but nobody will touch her due to her medical conditions so we are now stuck. A little girl who struggles to have a quality of life anyway is not being helped by our NHS..

We now have to look into going to Scotland to get the treatment… it’s a sad state of affairs & just shows me they are trying to privatise the NHS a little bit at a time.

NHS Live Well: “If free NHS treatment isn’t available, you can visit a clinic for private treatment but you’ll have to pay”

As soon as Clinical Commissioning Groups were set up on 1 April 2013, they were given the power to decide what footcare services to commission for their local area.

The NHS “Live Well” webpage of “Advice, tips and tools to help you make the best choices about your health and wellbeing” says,

Guidance by the National Institute for Health and Care Excellence (NICE) recommends that footcare services related to long-term conditions such as diabetes, peripheral arterial disease and rheumatoid arthritis should be available on the NHS.

But there’s no NICE guidance for foot health provision that isn’t associated with a long-term condition.

This means that each individual CCG will decide what to make available on the NHS, depending on local need…if free NHS treatment isn’t available, you can visit a local clinic for private treatment, but you’ll have to pay.

The NHS “Conditions” webpage advises patients,

“Your GP may be able to freeze a wart or verruca so it falls off a few weeks later. Sometimes it takes a few sessions.
Check with your GP if the NHS pays for this treatment in your area.
If treatment has not worked or you have a wart on your face, your GP might refer you to a skin specialist. Other treatments include minor surgery and treatment with laser or light.”

It’s just sad, especially for a child who thinks that doctors help

However, the little girl’s GP told her mother that the local Clinical Commissioning Group does not pay for this treatment. And the GP would not submit an Individual Funding Request to the Clinical Commissioning Group. (This would seem to be appropriate, given the little girl’s exceptional need.) The mother explained,

The GP won’t help at all, it’s just sad especially for a child who thinks that doctors help. She has seen so many in her life & mostly they have always helped her.

It’s hard telling her this time that they won’t help & it’s because of the government trying to save a measly amount of money instead of helping a 9 year old be able to walk properly, and to tell her that although mummy will find the money they won’t do it because of her illness. She doesn’t understand & nor do I! really angers me!

Why does the Clinical Commissioning Group not still fund NHS treatment for Verrucas in immuno-suppressed patients?

It seems some other Clinical Commissioning Groups do – at least a Surrey Downs 2013 policy document says so (p7). So why not the Clinical Commissioning Group that tells the little girl’s GP what he can and can’t do? CK999 is making an FOI request to find out.

Why is this child being put through this meanness? She deserves help from doctors. Not mean-spirited rejection based on public spending cuts. What is that teaching children, apart from anything else?

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