Every three to five years, the NHS Lancashire and South Cumbria ICB reviews its clinical policies to ensure they reflect the latest evidence-based guidance and best practice. We are currently reviewing the following policies and would welcome your views on the proposed changes.
Trigger finger happens when a tendon in the finger becomes swollen or irritated and struggles to glide smoothly. This makes the finger:
· Painful
· Stiff
· “Catch” or “lock” when bent or straightened
It is common and often improves with simple treatments. If it doesn’t improve then a surgical release may be necessary. The surgery is an outpatient procedure usually performed under local anaesthesia.
The current policy says that surgery for trigger finger can be funded when one or more of the following apply:
· The person has not improved after up to two steroid injections.
· Splinting the finger for 3–12 weeks has not helped.
· Symptoms come back after splinting or an injection.
· The finger becomes stuck in a bent position and cannot be straightened.
· Two other trigger fingers were already treated conservatively but did not improve.
· The patient has diabetes. (This was included as an automatic qualifier for surgery.)
You can read the full policy wording here: https://www.healthierlsc.co.uk/application/files/2516/7576/5524/LSCICB_Clin18_Policy_for_Surgical_Release_of_Trigger_Finger_v2.1.pdf
In order to bring the policy in line with new evidenced based guidance, we are proposing some changes as follows:
· The new policy adds additional criteria, including that symptoms must interfere with daily activities or cause pain.
· Additional clarity has been added by changing the wording of the steroid injection criteria to “one or two” injections.
· The required splinting period changes from 3–12 weeks to “at least 3 weeks”, making it more flexible.
· Diabetes is removed as an automatic reason for surgery
o The previous policy worked on the basis that diabetes could make the non-surgical treatments less effective and so people with diabetes could effectively go straight to surgery. Newer evidence shows diabetes alone does not make conservative treatment less effective and so this clause has been removed.
· Addition of 'multiple trigger digits'
o People with several fingers affected may qualify for surgery sooner because this increases the chance that non‑surgical treatments won’t work.
The new wording in full
The ICB will commission the surgical release of trigger finger when symptoms interfere with activities or cause pain AND one or more of the following criteria are met:
· The patient has failed to respond to one or two steroid injections.
OR
· The patient has failed to respond to splinting of the affected finger for at least three weeks.
OR
· Triggering has recurred after splinting or injection treatment.
OR
· The patient has a fixed deformity that cannot be corrected.
OR
· The patient has previously had 2 other trigger digits unsuccessfully treated with appropriate non-operative methods.
OR
· The patient has multiple trigger digits.
Please note this survey closes at midnight on 29th March 2026