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Evidence Based Intervention Policies

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The Evidence Based Interventions Programme is a clinical initiative led by the Academy of Medical Royal Colleges (AoMRC) in partnership with NHS England, as well as NHS Clinical Commissioners and the National Institute for Health and Care Excellence. 

The Evidence Based Intervention (EBI) Clinical Policies, assist NHS Bedfordshire, Luton and Milton Keynes Integrated Care Board to manage and prevent avoidable harm to patients, to avoid unnecessary operations, and to free up clinical time by only offering treatment on the NHS that is evidence-based and is clinically effective.

An EBI Clinical Policy outlines whether an intervention is not normally funded (INNF) or whether the intervention has a criteria based access (CBA). It is the responsibility of the clinicians and referrers to ensure patients meet the EBI policy criteria before referring or commencing treatment.

Patient support leaflets for some of the EBI Clinical Policies are available on the AoMRC website EBI for patients – EBI

Evidence Based Intervention (EBI) Clinical Policy:

Policy Type: Intervention Not Normally Funded (INNF) or Criteria Based Access

Keywords

Ankylosing spondylitis residential therapy

Intervention Not Normally Funded

Axial spondyloarthritis

Autologous Blood and Platelet-Rich Plasma Injection in tendinopathy

Intervention Not Normally Funded

autologous blood platelet-rich plasma Tendinopathy

Back pain: Non-specific low back pain – Radiofrequency denervation

Criteria Based Access

axial fusion injection Low back pain mechanical non-specific radiofrequency denervation rhizolysis

Back pain: Non-specific low back pain – Spinal fusion

Intervention Not Normally Funded

axial Low back pain mechanical non-specific

Back pain: Non-specific low back pain – Spinal injections

Intervention Not Normally Funded

axial injection Low back pain mechanical non-specific

Back pain: Sciatica (radicular low back pain)

Criteria Based Access

back pain discectomy epidural radicular pain radiculopathy sciatica

Benign skin lesions

Criteria Based Access

lipomas moles skin lesions skin tags warts

Blepharoplasty and Brow Lift

Criteria Based Access

blepharoplasty brow ptosis brow surgery dermatochalasis eyelid surgery

Body contouring procedures

Criteria Based Access

abdominoplasty apronectomy body contouring removal of excess skin tummy tuck

Breast surgery

Intervention Not Normally Funded/Criteria Based

breast augmentation breast implants breast reduction gynaecomastia

Bunions

Criteria Based Access

bunion hallus valgus painful great toe

Cataract Surgery

Criteria Based Access

cataract glaucoma intra ocular lens lens replacement surgery

Chalazia (meibomian cyst) in adults and children

Criteria Based Access

chalazia chalazion eye lid cyst meibomian cyst

Cholecystectomy

Criteria Based Access

cholecystectomy gallbladder gallstones

Chronic Fatigue Syndrome / Myalgic Encephalitis (CFS/ME): Inpatient therapy

Intervention Not Normally Funded

CFS Chronic Fatigue Syndrome ME Myalgic Encephalomyelitis

Chronic rhinosinusitis (adults and children)

Criteria Based Access

endoscopic sinus surgery ESS functional endoscopic sinus surgery nasal polyps Rhinosinusitis

Circumcision

Criteria Based Access

Circumcision

Coloured overlays for reading difficulty

Intervention Not Normally Funded

coloured Irlen-lenses lenses overlays reading difficulty specific reading difficulty tinted

Complementary and alternative therapies

Intervention Not Normally Funded

acupuncture alternative therapies chiropractic complementary therapies herbal medicine homeopathy osteopathy

Cosmetic treatments and surgery

Intervention Not Normally Funded

aesthetic procedures baldness birth marks body contouring Botox cosmetic procedures earlobes lobes hair loss hirsutism liposuction nipple/s pinnaplasty scar revision surgery to ear tattoo removal vascular lesions

Cough assist device

Criteria Based Access

cough assist Mechanical Insufflation-Exsufflation MI-E device

Divarication of the recti (abdominal muscles): surgical correction

Intervention Not Normally Funded

diastasis divarication of the recti DRAM

Dysthyroid eye disease; surgery

Intervention Not Normally Funded

Dysthyroid eye disease exophthalmos proptosis thyroid eye disease

EXOGEN® ultrasound bone healing system for the management of bone fractures

Criteria Based Access.

Exogen LIPUS low intensity pulsed ultrasound non-union fracture pseudarthrosis

Faecal microbiota transplants for clostridium difficile

Criteria Based Access

Clostridium Difficile Faecal microbiota transplants FMT

Fertility Services Commissioning Policy

Criteria Based Access

fertility infertility IVF

Functional Electrical Stimulation for neurological conditions

Criteria Based Access

FES Functional Electrical Stimulation neurological conditions

Gamete Storage BLMK Policy

Criteria Based Access

egg embryo fertility freeze frozen gamete infertility IVF sperm

Ganglion excision

Criteria Based Access

ganglia Ganglion

Gender reassignment: surgery and cosmetic interventions

Intervention Not Normally Funded

Gender dysphoria gender reassignment transgender

Grommet insertion in adults

Criteria Based Access

Eustachian tube dysfunction grommets

Grommets and adenoidectomy in children for otitis media with effusion (glue ear)

Criteria Based Access

adenoidectomy glue ear grommets OME otitis media with effusion

Haemorrhoid Surgery

Criteria Based Access

haemorrhoid haemorrhoidectomy

Hand surgery: Carpal tunnel syndrome, Trigger finger and Dupuytren’s contracture

Criteria Based Access

Carpal tunnel syndrome Dupuytren’s contracture hand surgery Trigger finger

Heavy Menstrual Bleeding (menorrhagia) – Dilatation and Curettage (D&C)

Intervention Not Normally Funded

D&C dilatation and curettage heavy menstrual bleeding HMB menorrhagia

Heavy Menstrual Bleeding (menorrhagia) – Surgical Interventions

Criteria Based Access

heavy menstrual bleeding HMB menorrhagia

Helmet therapy for treatment of positional plagiocephaly / brachycephaly

Intervention Not Normally Funded

brachycephaly flat head Helmet therapy positional plagiocephaly

Hernia repair in adults

Criteria Based Access

hernia

Hernia repair in adults – biological mesh for abdominal hernia repair

Intervention Not Normally Funded

biological mesh hernia mesh

Hip and knee replacement revision surgery

Criteria Based Access

conversion surgery hip revision knee revision

Hip arthroscopy

Criteria Based Access

Arthroscopy FAI Femoro‐Acetabular Impingement labral tears loose bodies sepsis

Hip replacement surgery (primary hip replacement)

Criteria Based Access

hip replacement hip resurfacing

Home Oxygen Prescribing BLMK Policy

Criteria Based Access

home oxygen smoking

Hyperhidrosis

Criteria Based Access

Hyperhidrosis

Hyperhidrosis – Endoscopic thoracic sympathectomy

Intervention Not Normally Funded

Hyperhidrosis

Hyperthermia Treatment

Intervention Not Normally Funded

hyperthermia infrared A whole body hyperthermia

Hysterectomy: Indications for surgery

Criteria Based Access

adenomyosis endometriosis fibroids hysterectomy leiomyoma pelvic inflammatory disease pelvic organ prolapse pelvic pain PID PMS premenstrual syndrome prolapse

Inpatient Pain Management Programmes

Intervention Not Normally Funded

chronic pain inpatient pain management programme Funded pain management PMP residential programme

Joint Injections: ultrasound guided joint injections (adults)

Criteria Based Access

joint injections ultrasound guided

Knee arthroscopy, arthroscopic surgery for osteoarthritis

Criteria Based Access

ACL anterior cruciate ligament knee arthroscopy Lavage debridement meniscal tear OA osteoarthritis synovectomy

Knee arthroscopy, arthroscopic washout for osteoarthritis

Intervention Not Normally Funded

ACL anterior cruciate ligament knee arthroscopy Lavage debridement meniscal tear OA osteoarthritis synovectomy washout

Knee replacement surgery (primary knee replacement)

Criteria Based Access

knee replacement partial knee replacement TKR total knee replacement unicompartmental knee replacement

Labiaplasty and vaginoplasty

Criteria Based Access

Labiaplasty vaginoplasty

Laser eye surgery in myopia

Intervention Not Normally Funded

myopia near-sightedness

Lipoedema: liposuction

Intervention Not Normally Funded

lipoedema liposuction

Lycra garments for children with neurological impairment

Intervention Not Normally Funded

dynamic splinting lycra garments

Lymphoedema: liposuction

Intervention Not Normally Funded

liposuction Lymphoedema

Open magnetic resonance imaging (MRI) scans

Criteria Based Access

magnetic resonance imaging Open MRI

Open MRI Prior Approval Form

PRIOR APPROVAL ONLY

magnetic resonance imaging Open MRI

Overweight and obese adults, weight management services (policy under review)

Criteria Based Access

bariatric surgery obesity overweight severe and complex obesity weight loss programme weight loss surgery

Penile rehabilitation following prostate surgery

Intervention Not Normally Funded

penile rehabilitation prostate surgery.

Peyronie’s disease; surgery and Extracorporeal Shockwave Therapy

Intervention Not Normally Funded

Extracorporeal Shockwave Therapy induration of the penis penile fibromatosis Peyronie’s

Reversal of sterilisation

Intervention Not Normally Funded

reversal sterilisation tubal occlusion vasectomy

Septoplasty, rhinoplasty and septorhinoplasty

Criteria Based Access

deviated septum rhinoplasty septoplasty septorhinoplasty

Shoulder arthroscopy

Criteria Based Access

adhesive capsulitis joint instability labral tears rotator cuff repair shoulder arthroscopy

Shoulder pain: subacromial decompression of the shoulder

Criteria Based Access

shoulder decompression shoulder pain subacromial

Simultaneous joint replacement surgery

Intervention Not Normally Funded

bilateral joint replacement simultaneous

Snoring surgery in adults (in the absence of obstructive sleep apnoea)

Intervention Not Normally Funded

mandibular advancement device mouth splints simple snoring snoring

Surrogacy

Intervention Not Normally Funded

Surrogacy

Tongue-tie: Division of ankyloglossia (tongue- tie) for infant feeding and speech problems

Criteria Based Access

ankyloglossia frenulotomy frenulum tongue-tie

Tonsillectomy for recurrent tonsillitis (children and adults)

Criteria Based Access

tonsillectomy tonsillitis tonsilloliths

Tonsillectomy for tonsilloliths

Intervention Not Normally Funded

tonsillectomy tonsillitis tonsilloliths

Varicose veins: management and surgery

Criteria Based Access

Varicose Veins

Video capsule endoscopy and balloon enteroscopy for small bowel investigation

Criteria Based Access

balloon enteroscopy device assisted enteroscopy small bowel investigation video capsule endoscopy