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<p>Since 1 April 2013 NHS England has been responsible for securing high quality health
outcomes for patients in England.</p><p> </p><p> </p><p> </p><p>The symptoms of Dupuytren's
contracture are often mild and painless and do not require treatment. However, for
a small number of patients, surgery may be beneficial. In November 2013, NHS England
published a commissioning policy statement for surgery for the condition. Although
the policy sets out that surgery is not routinely funded, it also sets out criteria
by which patients with the most serious symptoms may be eligible for treatment which
are:</p><p> </p><p> </p><p> </p><p>- the patient has a 30 degree fixed flexion deformity
at either the metacarpophalanageal joint or proximal interphalangeal joint; and</p><p>
</p><p>- the patient cannot flatten their fingers or palm on a table; or</p><p> </p><p>-
there has been rapid progression over a few months.</p><p> </p><p> </p><p> </p><p>If
a patient does not meet the criteria, their clinician may submit an individual funding
request to NHS England.</p><p> </p><p> </p><p> </p><p>In addition, the National Institute
for Health and Care Excellence published an interventional procedures (IP) guideline
on treatment with needle fasciotomy in 2004 and an IP guideline on radiation therapy
in 2010. These guidelines advise commissioners on the safety and effectiveness of
procedures.</p><p> </p><p><strong> </strong></p><p> </p><p><strong> </strong></p><p>
</p><p><strong> </strong></p><p> </p><p><strong> </strong></p><p> </p>
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