Hernia patients must prove their pain to get surgery

HERNIA patients are being forced to prove they are in so much pain they cannot go to work before they are given an operation, a report has found.

A survey by the Royal College of Surgeons found that most local health chiefs are now refusing to pay for surgery until patients are so debilitated that their everyday life is affected.

Only a quarter are following clinical guidelines, putting people whose hernias worsen rapidly at risk of death.

Leading surgeons described the restrictions as an “absolute disgrace” and called on ministers to intervene.

A groin hernia usually occurs when a weakness in the abdominal wall allows fatty tissue or a part of the bowel to protrude into the inguinal canal.

It can cause pain and lead to severe complications if untreated. Surgery is the only form of curative treatment but if a patient is treated as an emergency the mortality rate is seven times worse.

In 2016-17, around 78,733 groin hernia procedures were carried out in hospitals in England.

Around 3,700 of these patients had to be operated on as an emergency because their symptoms were so serious. David Sanders, of the British Hernia Society, said: “It is simply not acceptable to justify restrictive criteria as best practice. This denies patients access to a procedure that potentially limits pain and improves quality of life.”

The new figures follow a steady stream of reports in the past two years revealing the extent of rationing being practised by local NHS commissioners.

Additional restrictions on hip and knee replacements, as well as surgery to address obesity, are also commonly employed in areas under financial strain. Susan Hill, the senior vice president of the Royal College of Surgeons, said: “It is an absolute disgrace that some patients have to demonstrate what could be a life-threatening complication of a hernia, which is one of the most straightforward surgical conditions to treat.

“Instead of asking patients to prove their pain, ministers and NHS England should immediately intervene to allow patients to talk to their surgeon about whether they need an operation.

“Allowing commissioning groups, not patients with their surgeon, to make a decision to operate is putting patients at unnecessary risk of serious complications.”