Updating clinical policies could increase access for some - have your say

Residents in Lancashire and South Cumbria are being encouraged to have their say as the NHS updates three more of its policies on treatments.

The NHS Lancashire and South Cumbria Integrated Care Board (ICB) regularly reviews its clinical policies to ensure they reflect the latest evidence-based guidance and best practice.

As part of this ongoing process, three clinical policies are being reviewed and could mean more people access those treatments in the future.

The policy for carpal tunnel syndrome surgery, when a nerve in the wrist (the median nerve) becomes compressed and causes pain, is being broadened with provision for recurring cases being added. The time period in which other treatments must be tried before surgery is allowed is also being made more flexible.

People with certain bladder conditions could see an increase in provision of sacral neuromodulation which is where a small device sends gentle electrical signals to nerves in the lower back (sacral nerves).

Under the new policy some people with overactive bladder could be given access to the treatment who wouldn’t have been before.

There are some alterations planned for the policy for surgical release of trigger finger. Trigger finger happens when a tendon in the finger becomes swollen or irritated and struggles to glide smoothly and can be painful. Many people improve with simple treatments like splints or steroid injections. If they don’t work a surgery is offered which is an outpatient procedure usually performed under local anaesthesia. Between September 2024 and August 2025, 262 people in Lancashire and South Cumbria underwent the surgery.

Under the proposed changes a new condition is added that says surgery is only permitted if the other treatments have failed and the patient is experiencing pain or restricted daily activity as a result of the trigger finger. This may mean some people cannot have the surgery but also means that surgery is not being carried out without good reason.

People with diabetes will also see a change in that it was previously believed the non-surgical treatments were ineffective for people with diabetes, so they were allowed to bypass those treatments and go straight for surgery. New evidence shows that they are effective and so the proposed policy is aligned to this and people with diabetes are subject to the same criteria as everyone else.

However, people who have multiple fingers affected by the condition could skip the non-surgical treatments and be eligible for surgery straight away.

Dr Andy Curran, associate medical director at the ICB, said: “Reviewing clinical policies is a rolling programme and sometimes results in changes being made and policies needing to be updated.

“Some of the proposed changes are only small such as clarification of previously ambiguous terms. Some of them have more of an impact and sometimes they can increase availability of treatments. They are always based on national guidelines and best clinical practice to make sure that the resources available are being used to maximum effect for the local population.

“We know how important it is that this is done in an open, fair and transparent manner and that local patients and the public have the opportunity to have their say. I would encourage any resident with an interest in these policies to visit the ICB website and take part in the survey.”

For more information about current clinical policy reviews and to have your say, visit:  www.lancashireandsouthcumbria.icb.nhs.uk/have-your-say/get-involved-across-lancashire-and-south-cumbria/clinical-policies