Hallux Valgus – Bunions

(Surgical Management – Including Osteotomy)

Threshold

Norfolk and Waveney Integrated Care Board (ICB) will fund surgery for patients if the following criteria are met and evidenced in clinic letters:

• Significant and persistent pain when walking AND conservative measures tried for at least six months (e.g. toe spacers, bunion pads, medication or altered footwear) do not provide symptomatic relief

OR

• Ulcer development at the site of the bunion or the sole of the foot

OR

• Evidence of severe deformity (overriding toes)

OR

• Physical examination and X-ray show degenerative changes in the 1^st metatarsophalangeal joint, increased intermetatarsal angle and/or valgus deformity > 15 degrees

Note: This procedure is not funded for cosmetic reasons or for asymptomatic or mild symptomatic hallux valgus.

Cases for Individual Funding Consideration (Patients who do not meet the policy criteria)

On a case to case basis, patients might be eligible for surgical intervention, in consideration of their exceptionality. The requesting clinician must provide information to support the case for being considered an exception, by submitting an individual funding request.