Title |
‘Cosmetic boob jobs’ or evidence-based breast surgery: an interpretive policy analysis of the rationing of ‘low value’ treatments in the English National Health Service
|
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Published in |
BMC Health Services Research, September 2014
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DOI | 10.1186/1472-6963-14-413 |
Pubmed ID | |
Authors |
Jill Russell, Deborah Swinglehurst, Trisha Greenhalgh |
Abstract |
In England the National Health Service (NHS) is not allowed to impose 'blanket bans' on treatments, but local commissioners produce lists of 'low value' procedures that they will normally not fund. Breast surgery is one example. However, evidence suggests that some breast surgery is clinically effective, with significant health gain. National guidelines indicate the circumstances under which breast surgery should be made available on the NHS, but there is widespread variation in their implementation.The purpose of this study was to explore the work practices of 'individual funding request' (IFR) panels, as they considered 'one-off' funding requests for breast surgery; examine how the notion of 'value' is dialogically constructed, and how decisions about who is deserving of NHS funding and who is not are accomplished in practice. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 58 | 38% |
United States | 10 | 7% |
Australia | 2 | 1% |
Ireland | 2 | 1% |
Canada | 2 | 1% |
Poland | 1 | <1% |
Netherlands | 1 | <1% |
Austria | 1 | <1% |
Papua New Guinea | 1 | <1% |
Other | 6 | 4% |
Unknown | 67 | 44% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 80 | 53% |
Practitioners (doctors, other healthcare professionals) | 40 | 26% |
Scientists | 27 | 18% |
Science communicators (journalists, bloggers, editors) | 4 | 3% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 59 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 9 | 15% |
Researcher | 8 | 14% |
Student > Master | 8 | 14% |
Student > Doctoral Student | 6 | 10% |
Other | 4 | 7% |
Other | 12 | 20% |
Unknown | 12 | 20% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 19 | 32% |
Social Sciences | 8 | 14% |
Psychology | 5 | 8% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 3% |
Business, Management and Accounting | 2 | 3% |
Other | 9 | 15% |
Unknown | 14 | 24% |