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This is a summary of the Northern, Eastern and Western CCG and South Devon & Torbay CCG commissioning policy for the referral and specialist management of haemorrhoids in adults
Referral for specialist assessment and treatment of haemorrhoids is not routinely commissioned in Devon.
Referral will only be funded if:
The haemorrhoids are prolapsed and incarcerated, and cannot be reduced (Fourth degree haemorrhoids)
The haemorrhoids are recurrent and associated with persistent bleeding
There is failure of documented conservative management techniques after at least three months.
Non-surgical measures (rubber band ligation, injection sclerotherapy or infra-red coagulation) will only be commissioned in the following circumstances:
Failure of documented conservative management techniques after at least three months.
Surgical treatment (haemorrhoidectomy, stapled haemorrhoidopexy or haemorrhoidal artery ligation) will only be commissioned in the following circumstances:
Third-degree haemorrhoids associated with persistent bleeding that have not responded to non-surgical treatment in line with the above policy statement, or which are too large for non-surgical measures
Second-degree haemorrhoids associated with persistent bleeding that have not responded to non-surgical treatment in line with the above policy statement
The removal of anal skin tags is not routinely commissioned in Devon.
Where the circumstances of treatment for an individual patient do not meet the criteria described above exceptional funding can be sought. Individual cases will be reviewed by the appropriate panel of the CCG upon receipt of a completed application from the patient's GP, consultant or clinician. Applications cannot be considered from patients personally.
Applications for consideration for funding approval should be sent to:
Alternatively, please send to: The Panel administrator at Bridge House, Collett Way, Newton Abbot, TQ12 4PH
Northern, Eastern and Western Devon Clinical Commissioning Group South Devon and Torbay Clinical Commissioning Group
Date of publication: 1 December 2015