Policy Category:
INNF
Who usually applies for funding?
GP
Skin and subcutaneous procedures
Commissioning
decision
Treatment for a range of skin and subcutaneous procedures is
considered a low priority for funding and will only be considered
in exceptional circumstances.
Funding approval must be sought from the CCG via the Individual
Funding Request process prior to treatment. Applications for
referral to secondary care for surgery must be clear about why
the patient is not suitable for surgery within Primary Care through
the Minor Surgery Direct Enhanced Service.
Policy Statement:
Treatment can be considered in case of;
 Severe disfiguring non-malignant lesions of the face
 Severe port wine stains that extend onto the face and neck

(For the above, requests to be supported by photographic evidence or confirmation of
the extent to which the face is covered, taking into account the patient’s normal
hairstyle)
 Clinical concern regarding significant malignant potential
Destructive interventions to treat other asymptomatic and unchanging skin lesions are not
normally funded including the treatment of:
o Warts
o Seborrhoeic keratoses (benign skin growths, basal cell papillomas, warts)
o Spider Naevi
o Benign pigmented naevi (moles)
o Dermatofibromas (skin growths)
o Skin tags
o ‘Sebaceous’ cysts (pilar and epidermoid cysts)
o Lipomata (fat deposits underneath the skin)
o Xanthelasmas (cholesterol deposits underneath the skin)
Where removal of lipomata and sebaceous (pilar) cysts is supported, the CCG expects
removal to generally be undertaken in Primary Care through the Minor Surgery Direct
Enhanced Service. Treatment in secondary care will only be approved where the removal is
beyond GP surgical care.
Other procedures not normally funded;
 Keloid and hypertrophic scars, cosmetic scar revision is not normally funded, exceptions
will only be considered where scarring impacts severely on physical function.
Symptomatic keloid scars (itching or pain) can be treated in primary care with topical or
intralesional steroids.
 Labiaplasty (unless where labia are directly contributing to recurrent urinary tract disease
or infection or where repair of the labia is required after trauma)
 Vaginoplasty, hymenopathy
 Penile enlargement
 Tattoo removal (by any method)
 Skin ‘resurfacing’ e.g., dermabrasion, laser and chemical peels
 Treatments for hirsutism / hair depilation
1
Policy Category:
INNF
Who usually applies for funding?
GP
Rationale:
Removal of clinically benign skin lesions is considered a low priority and will not routinely be
funded by the CCG.
Plain English Summary:
Benign skin lesions include a wide range of skin disorders such as sebaceous cyst, dermoid
cyst, skin tags, hirsutism, milia, molluscum contagiosum, seborrhoeic keratoses (basal cell
papillomata), spider naevus (telangiectasia), warts, sebaceous cysts, xanthelasma,
dermatofibromas, benign pigmented moles, comedones and corn/callous. There is no
clinical need to remove benign skin lesions, and as such surgical removal is not generally
available through the NHS.
If your doctor believes that you have exceptional circumstances that would warrant removal
of your skin lesion they are able to submit an Individual Funding Request application to the
CCG for consideration.
Evidence base:
Information for commissioners of Plastic Surgery - referrals and guidelines in Plastic Surgery
Modernisation Agency (Action on Plastic Surgery) (2005)
Link to application form – Individual Funding Request Application form
For further information please contact GLCCG.IFR@nhs.net
Date of publication
Policy review date
1st August 2015
June 2017
Consultation
Consultee
Planned Care Programme Board
CCG Governing Body Development Session
GHNHSFT (via General Manager/Head of Contracts)
GP Membership (via CCG Live/What’s New This Week)
Date
31st March 2015 (virtual)
4th June 2015
18/05/2015 – 29/05/2015
06/05/2015 – 05/06/2015
Has the consultation included patient representatives?
No
Policy sign off
Reviewing Body
Effective Clinical Commissioning Policy Group
Integrated Governance and Quality Committee
2
Date of review
14th April 2015
18th June 2015