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Part of SUS+ PbR reference manual

Evidence-based interventions

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Current chapter – Evidence-based interventions

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Extracted from the guidance “Evidence-Based Interventions: Guidance for CCGs”.

The programme as a whole, is guided by the following 5 goals:

Reduce avoidable harm to patients

With surgical interventions, there is always a risk of complications. Weighing the risks and benefits of appropriate treatments should be co-produced with patients.

Save precious professional time

When the NHS is severely short of staff, professionals should offer appropriate and effective treatment to patients.

Help clinicians maintain professional practice

Help clinicians maintain their professional practice and keep up to date with the changing evidence base and best practice.

Create headroom for innovation

If we want to accelerate the adoption of new, proven innovations, we need to reduce the number of inappropriate interventions. This allows innovation in healthcare, prescribing and technology to improve patients’ ability to self-care and live with long term conditions.

Maximise value and avoid waste

Inappropriate care is poor value for the taxpayer. Resources should be focused on effective and appropriate NHS services


17 interventions have been identified and placed into 2 groups:

Interventions that should not be routinely commissioned

There are 4 interventions that should not be routinely commissioned. Patients should only able to access such treatments where they successfully make an individual funding request (Category 1 interventions).

These are:

  • adult snoring surgery (A_snoring)
  • dilation and curettage for heavy menstrual bleeding (B_menstr_D&C)
  • knee arthroscopy with osteoarthritis (C_knee_arth)
  • injections for nonspecific low back pain without sciatica (D_low_back_pain_in)

Interventions that should be commissioned

There are 13 further interventions that should be commissioned or performed when specific criteria are met (Category 2 interventions). The full list is found in “Evidence-Based Interventions: Guidance for CCGs”.

SUS+ derivation

SUS+ will identify Category 1 only and will add 2 new columns to APC spells and full online extracts (and their “plus” equivalents). The columns are:

  • Evidence Based Intervention Category
  • Evidence Based Intervention Type
    • A_snoring
    • B_menstr_D&C
    • C_knee_arth
    • D_low_back_pain_inj

It is anticipated in future years these columns will be used to identify further categories.

In 2019/20 for “Evidence Based Intervention Category” only the value “1” will be used.

Payment for Category 1 is dependent on individual funding requests (which do not flow to SUS+). SUS+ will therefore continue to price this activity.

The clinical codes for the full algorithm used by SUS+ are found in the guidance “Evidence-Based Interventions: Guidance for CCGs”.

Last edited: 6 June 2022 5:07 pm