Policy number: SRP 064
Policy name: Hysteroscopy/Dilatation and Curettage (D&C)
Status: Group Prior Approval
Effective date: 1 April 2024
Next review date: 1 April 2026
Mid and South Essex ICB commissions Hysteroscopy/Dilatation and Curettage (D&C) on a restricted basis.
MSE ICB will only fund Hysteroscopy/D&C when used in line with NICE guidance (NG88).
Hysteroscopy will only be funded for the investigation and management of heavy menstrual bleeding when it is carried out:
- as an investigation for structural and histological abnormalities with suspected submucosal fibroids, polyps or endometrial pathology
OR
- immediately prior to the ablative procedure to ensure correct placement of the device where endometrial ablation is required.
The ICB will not fund D&C:
- as a diagnostic tool for heavy menstrual bleeding
OR
- as a therapeutic treatment for heavy menstrual bleeding
Postmenopausal women who have had a pelvic scan and endometrial biopsy and who present with further bleeding 6 months later should be offered hysteroscopy to be sure no small cancer has been missed without a mandatory preliminary scan.
Hysteroscopy for the majority of women should be performed as an outpatient procedure.
Funding for patients not meeting the above criteria will only be made available in clinically exceptional circumstances.
Find out more information on applying for funding in exceptional clinical circumstances
References:
Heavy menstrual bleeding: assessment and management
NICE guideline [NG88] Published date: March 2018 https://www.nice.org.uk/guidance/ng88/resources