Cosmetic surgery in the NHS: Applying local and national guidelines

J Plast Reconstr Aesthet Surg. 2010 Sep;63(9):1437-42. doi: 10.1016/j.bjps.2009.08.012. Epub 2009 Sep 22.

Abstract

There is no worldwide consensus, as to how healthcare should be funded, in a modern society. Limited resources in the UK, have led to restrictions on cosmetic surgery in the NHS. Guidelines governing access to cosmetic surgery have been formulated. A retrospective audit has been undertaken, to assess adherence to local and national guidelines, in an NHS trust. Ninety-nine casenotes were reviewed over 1 year. Data on complications were collected. Compliance to local guidelines was 44% and to national guidelines was 22%. Complication rate was 23% in guideline compliant patients and 55% in non-compliant patients (P<0.005). Guidelines are difficult to follow in practice. Total adherence to guidelines would reduce waiting lists and complications, but some needy patients could be denied treatment. In practice, rigid adherence to guidelines is not possible.

MeSH terms

  • Abdomen / surgery*
  • Body Mass Index
  • Breast Diseases / surgery*
  • Chi-Square Distribution
  • Female
  • Guideline Adherence*
  • Humans
  • Male
  • Mammaplasty / standards*
  • Postoperative Complications / epidemiology
  • Practice Guidelines as Topic*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Retrospective Studies
  • Smoking / epidemiology
  • State Medicine*
  • Surgery, Plastic / standards*
  • United Kingdom / epidemiology