NHS cash row brings delays in hand-swap surgery

A year ago today, Yorkshireman Mark Cahill became the first in the UK to receive a hand transplant performed by a pioneering team at Leeds General Infirmary.

But no further operations have since been carried out despite two patients being assessed as suitable for the procedure and it might be 2015 at the earliest before they can undergo surgery.

The delays follow the biggest-ever reconfiguration of the NHS. Clinical commissioning groups (CCGs), which have been given charge of the bulk of NHS spending including hand transplant surgery, are refusing to finance the operations, claiming it is the responsibility of NHS England which pays for specialised care.

The funding dispute is believed to be among a number due to the complex shake-up in April.

Internationally-renowned specialist Prof Simon Kay, who heads the transplant team in Leeds, told the Yorkshire Post he was frustrated at the delay.

Both patients, one from the East of England and another from London, could be operated on “immediately” if funding of £66,000 for the first year was available, with further life-time costs mainly for anti-rejection drugs running into several thousand pounds a year.

“We are saying this is clearly the responsibility of the CCGs. If they want to say no to it, they have to give a good clinical reason and there isn’t one,” said Prof Kay.

“Surgery would be life transforming for both patients. We could go ahead now – we are up and ready to go.

“NHS England have been very constructive. The people who haven’t got up to speed are the CCGs in this respect. We certainly hope it can be resolved. They really do need to understand the value for their patients and move quickly.”

Instead a patient from Scotland is likely to be the next to undergo a transplant in the summer as funding north of the border, which has had no re-organisation, is available.

Prof Kay added: “It will mean a Scottish patient will have treatment in England when an English patient can’t at the moment. It really does need to be sorted out.”

The Leeds team say they are very pleased with the progress of Mr Cahill, of Greetland, near Halifax, who is gaining improved movement and feeling in his new hand.

NHS England said: “The specialised services that are the responsibility of NHS England are set out in regulations and are determined by Ministers. Other hospital services are the responsibility of CCGs, including, at present, hand transplant.

“Ministers are looking at whether, during the next phase of deciding which services will be specialised, this service should become a prescribed service. In the meantime it remains the responsibility of CCGs to decide whether this surgery should be funded or not.”

In a separate case, the family of eight-year-old Joseph Hill, of Wakefield, was forced to raise £20,000 for a life-changing operation in October to help him walk.

The youngster, who has a form of cerebral palsy, was due to have selective dorsal rhizotomy at the Leeds General Infirmary paid for by the NHS. But following the re-organisation, NHS England said it was not routinely funding the procedure, which had been previously paid for by the NHS, and cancelled the operation.