There has long been concern from professional bodies that commissioning approaches based on lists of procedures deemed to be of ‘limited effectiveness’, ‘low value’ or requiring a ‘threshold’ result in inequitable patterns of service delivery – leading to press assertions that a ‘postcode lottery’ has been disadvantaging some patients.

In 2012 an ambitious and pioneering project was launched, led for Right Care by Nigel Beasley, a Nottingham-based ENT surgeon and Deputy Medical Director for NHS England, in partnership with the Royal College of Surgeons of England (RCSEng) and the Surgical Specialty Associations (SSAs), where strong engagement with surgeons, commissioners, other healthcare professionals and patients is establishing clear, consistent and credible value-based commissioning guidelines for a wide range of surgical procedures, in order to produce better-value clinical practice.

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