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Individual funding requests and planned procedure with a threshold

Proposed new policy: Management of Hallux Valgus (Bunions)

Hallux valgus (Bunions) refers to a lateral angulation of the great toe, overlying the second toe in very severe cases. The resulting prominence of the first metatarsal head is susceptible to developing inflammation in the overlying soft tissue and bursa, leading to the symptoms described above.

Management of hallux valgus is aimed at relieving symptoms, reducing deformity and preventing complications such as gait or balance problems and increased risk of falls.

The scope of the policy review is surgical procedures and the suggested thresholds are:

Conservative management has been tried for at least six months

AND

2) There is progression in pain, deformity and functional impairment despite conservative management

OR

There is involvement of the second toe or secondary foot problems such as neuritis/nerve entrapment, ulceration, or inflammatory conditions of the first metatarsal head (e.g. bursitis or tendinitis)

AND

3) Significant co-morbidities (such as cardiorespiratory diseases and diabetes) have been optimised

AND

4) The patient has been engaged in the shared decision making process