NHS Lancashire and South Cumbria ICB regularly reviews its clinical policies to ensure they reflect the latest evidence-based guidance and best practice. This is a rolling programme and sometimes results in changes being made to the policies.
We are currently reviewing the Bunion, surgical removal surgery policy and would welcome your views on the proposed changes.
Bunions are bony lumps that form on the side of the feet.
The skin may be damaged in the area of the bunion causing pain on walking, difficulty with footwear and concerns about its appearance. In some cases, they may cause people to struggle with their balance.
They can be much worse and lead to additional complications for people with diabetes.
This is a new clinical policy across the LSC ICB footprint. There was a previous policy that covered the former CCG area in Greater Preston but this was not updated when the previous eight CCGs in Lancashire and South Cumbria were abolished in 2022 and the ICB was formed.
The proposed policy is currently in force within Cheshire and Merseyside ICB.
Under the new policy the surgical removal of bunions is not routinely funded. A patient can however be referred for a surgical opinion (which may lead to the surgery being undertaken) if other treatments have not worked when tried for at least three months AND they have pain or the bunion is causing a disability.
New wording in full
Surgical removal of bunions (hallux valgus) is not routinely commissioned for cosmetic reasons alone.
Patients may be referred for a surgical opinion if all of the following criteria have been satisfied:
They have failed to respond to at least 3 months of conservative treatments. (These include footwear modification, bunion pads, insoles, simple analgesics, orthotics, physiotherapy).
AND
Experience pain under the ball of the foot and/or functional disability.