Procedures of Limited Clinical Value

‘Procedures of Limited Clinical Value’ (or PolCV) traditionally referred to treatments that do not have sufficient data to prove their cost effectiveness or clinical benefit. It was originally applied to treatments such as alternative and complementary therapies and cosmetic procedures. Procedures included on these lists were generally not funded by NHS commissioners.[1]

However, commissioners are increasing using PoLCV as a way to control spending by limiting access to treatments and technologies that are proven to be effective. Ration Watch conducted analysis of all 195 CCGs to look at the types of procedures they include on PoLCV lists.

Ration Watch found a number of proven treatments included on PoLCV lists. Four of the treatments listed most frequently were – hernia repair, cataract removal, Constant Glucose Monitoring and hip and knee replacements. Most commonly with these procedures, CCGs are using access thresholds to limit patient access.

	Hernia	Cataract	Continuous Glucose Monitoring	Hip and knee replacement
Airedale, Wharfedale and Craven CCG	X			X
Ashford CCG	X		X
Barking and Daganham CCG	X		X
Barnet CCG
Barnsley CCG	X	X		X
Basildon and Brentwood CCG	X	X
Bassetlaw CCG	X
Bath and North East Somerset CCG
Bedfordshire CCG	X	X	X	X
Bexley CCG
Birmingham and Solihull CCG	X	X		X
Blackburn with Darwen CCG	X
Blackpool CCG
Bolton CCG		X
Bradford City CCG
Bradford Districts CCG
Brent CCG		X		X
Brighton and Hove CCG	X			X
Bromley CCG
Buckinghamshire CCG	X	X
Bury CCG	X	X
Calderdale CCG
Cambridgeshire and Peterborough CCG	X	X	X
Camden CCG
Cannock Chase CCG		X		X
Canterbury and Coastal CCG	X		X	X
Castle Point and Rochford CCG	X	X		X
Central London (Westminster) CCG		X		X
Chorley and South Ribble CCG
City and Hackney CCG			X
Coastal West Sussex CCG	X			X
Corby CCG		X
Coventry and Rugby CCG	X	X
Crawley CCG	X			X
Croydon CCG
Darlington CCG	X
Dartford, Gravesham and Swanley CCG	X		X	X
Doncaster CCG	X	X		X
Dorset CCG
Dudley CCG		X		X
Durham Dales, Easington and Sedgefield CCG	X
Ealing CCG		X		X
East and North Hertfordshire
East Berkshire CCG		X
East Lancashire CCG
East Leicestershire and Rutland CCG		X
East Riding of Yorkshire CCG
East Staffordshire CCG		X		X
East Surrey CCG	X	X
Eastbourne, Hailsham and Seaford CCG	X			X
Eastern Cheshire CCG		X		X
Enfield CCG
Erewash CCG	X	X		X
Fareham and Gosport CCG	X	X
Fylde and Wyre CCG
Gloucestershire CCG
Great Yarmouth and Waveney CCG	X	X
Greater Huddersfield CCG
Greater Preston CCG
Greenwich CCG
Guildford and Waverley CCG	X			X
Halton CCG		X		X
Hambleton, Richmondshire and Whitby CCG	X
Hammersmith and Fulham CCG		X		X
Hardwick CCG	X	X		X
Haringey CCG
Harrogate and Rural District CCG		X
Harrow CCG		X		X
Hartlepool and Stockton-on-Tees CCG	X
Hastings and Rother CCG	X			X
Havering CCG	X		X
Herefordshire CCG		X		X
Herts Valleys CCG	X	X		X
Heywood, Middleton and Rochdale CCG	X	X
High Weald Lewes Havens CCG	X			X
Hillingdon CCG		X		X
Horsham and Mid Sussex CCG	X			X
Hounslow CCG		X		X
Hull CCG				X
Ipswich and East Suffolk CCG	X	X		X
Isle of Wight CCG			X	X
Islington CCG
Kernow CCG	X	X
Kingston CCG		X
Knowsley CCG		X
Lambeth CCG
Leeds CCG
Leicester City CCG		X
Lewisham CCG		X		X
Lincolnshire East CCG	X	X		X
Lincolnshire West CCG	X	X		X
Liverpool CCG		X		X
Luton CCG				X
Manchester CCG		X
Mansfield and Ashfield CCG		X
Medway CCG	X		X	X
Merton CCG		X
Mid Essex CCG	X	X
Milton Keynes CCG
Morecambe Bay CCG
Nene CCG		X
Newark and Sherwood CCG		X
Newcastle Gateshead CCG	X
Newham CCG			X
NHS Berkshire West CCG	X	X		X
NHS Bristol, North Somerset and South Gloucestershire CCG	X	X		X
NHS South East Staffordshire and Seisdon Peninsula	X	X
North Cumbria	X		X
North Derbyshire
North Durham CCG	X
North East Essex CCG	X	X
North East Hampshire And Farnham CCG	X	X
North East Lincolnshire CCG
North Hampshire CCG	X	X
North Kirklees CCG
North Lincolnshire CCG
North Norfolk CCG	X	X		X
North Staffordshire CCG				X
North Tyneside CCG
North West Surrey CCG	X
North, East, West Devon CCG
Northumberland CCG	X
Norwich CCG	X	X		X
Nottingham City CCG	X	X
Nottingham North And East CCG	X	X
Nottingham West CCG	X	X
Oldham CCG	X	X
Oxfordshire CCG				X
Portsmouth CCG	X	X
Redbridge CCG	X	X
Redditch and Bromsgrove CCG	X	X
Richmond CCG
Rotherham CCG	X			X
Rushcliffe CCG	X	X
Salford CCG
Sandwell and West Birmingham		X		X
Scarborough And Ryedale CCG
Sheffield CCG	X			X
Shropshire CCG	X	X		X
Somerset CCG	X	X		X
South Cheshire CCG	X	X		X
South Devon And Torbay CCG
South Eastern Hampshire CCG
South Kent Coast CCG	X		X	X
South Lincolnshire CCG	X	X		X
South Norfolk CCG	X	X		X
South Sefton CCG		X		X
South Tees CCG
South Tyneside CCG
South Warwickshire CCG	X	X
South West Lincolnshire CCG	X	X		X
South Worcestershire CCG	X	X
Southampton City CCG	X	X
Southend CCG	X	X		X
Southern Derbyshire CCG		X
Southport and Formby CCG		X		X
Southwark CCG
St Helens CCG		X		X
Stafford and Surrounds CCG		X		X
Stockport CCG		X
Stoke on Trent CCG		X		X
Sunderland CCG
Surrey Downs CCG	X	X		X
Surrey Heath CCG	X
Sutton CCG		X
Swale CCG	X		X	X
Swindon CCG
Tameside and Glossop CCG		X
Telford And Wrekin CCG	X	X		X
Thanet CCG	X		X	X
Thurrock CCG			X
Tower Hamlets CCG			X
Trafford CCG		X
Vale Of York CCG
Vale Royal CCG	X
Wakefield CCG	X	X		X
Walsall CCG	X	X
Waltham Forest CCG			X
Wandsworth CCG		X		X
Warrington CCG		X		X
Warwickshire North CCG
West Berkshire CCG	X	X
West Cheshire CCG	X			X
West Essex CCG	X	X
West Hampshire CCG	X	X
West Kent CCG	X		X	X
West Leicestershire CCG		X
West London CCG		X		X
West Norfolk CCG	X	X		X
West Suffolk CCG	X	X		X
Wigan Borough CCG		X
Wiltshire CCG	X	X
Wirral CCG	X			X
Wolverhampton CCG		X		X
Wyre Forest CCG	X	X