Unapproved healthcare services

Cardiac

• External counter pulsation therapy
• Insertion of implantable cardiac event monitor (e.g. Reveal device)
• Intravascular lithotripsy (IVL) for peripheral vascular disease
• Lead-less pacemaker (Medtronic Micra)
• Minimally invasive aortic valve surgery
• Replacement pacemaker (appliance)
• Personalised external aortic root support (PEARS)
• Sutureless cardiac valve and surgery (other than when the valve cost does not exceed the surgically implanted heart valve maximum as listed on the List of Prostheses and Specialised Equipment)
• Transcatheter aortic valve implantation (TAVI) (other than when using the transfemoral approach)
• Transcatheter mitral valve repair or replacement (e.g. MitraClip, PASCAL)
• Transcatheter tricuspid valve repair or replacement (e.g. TriClip, Cardioband, PASCAL)

Ear, nose and throat (ENT)

• Insertion of bone conduction implant (e.g. BAHA, BONEBRIDGE)
• Cochlear implant replacement receiver/stimulator appliance
• Eustachian tube injections
• Intranasal phototherapy (e.g. Rhinolight)
• Insertion of LATERA nasal implant
• Laser ear surgery (except for laser mastoidectomy, laser revision mastoidectomy, laser tympanoplasty, laser second look tympanoplasty, laser middle ear adhesiolysis, laser stapedectomy, laser medial canalplasty, and laser myringotomy)
• Sleep apnoea surgery
• Vidian neurectomy

General surgery

• Anti-reflux mucosal ablation (ARMA)
• BRAVA assisted breast reconstruction
• Bulking agents including PTQ silicone microspheres
• Colon Capsule Endoscopy
• Colonic chromoendoscopy
• EndoStim therapy
• Endoscopic Full Thickness Resection
• Endobronchial ultrasound (EBUS)
• Fascia preserving device (FPD) (e.g. Fasciotens)
• Gastroduodenal artery embolisation
• Laser ablation of common bile duct stones
• Lloyd release procedure
• Portal vein embolisation
• Stretta procedure
• Transanal total mesorectal excision of the rectum (TaTME)
• Video-assisted fistula tract/sinus ablation (e.g. VAAFT, VAAPS)

Gynaecology

• Hymenorrhaphy
• Labiaplasty
• Laparoscopic ovarian vein clipping
• Laser treatment for atrophic vaginal changes (e.g. MonaLisa Touch)
• Laser treatment for urinary incontinence (e.g. FemiLift)
• MRI-guided ultrasound for ablation of uterine fibroids

Imaging

• 123Iodine scan of the thyroid and whole body (Radioactive iodine uptake test, RAIU test)
• 3D volumetric photography
• Breast thermography
• Carotid intima-media thickness test (CIMT)
• Clinical photography
• CT calcium scoring, except as part of CT coronary angiography (CTCA)
• CT MARS Bioimaging
• Gastrointestinal ultrasound (GIUS)
• Radionuclide imaging of the GI tract using tauroselcholic acid (75-se; SeHCAT)
• Secretin enhanced MRCP
• Smart seed markers (e.g. Radar “SAVI SCOUT” or Magnetic “Magseed" markers)

Interventional radiology

• Cryoablation of central or peripheral nerve
• Prostate Artery Embolisation
• Radiofrequency ablation of Morton's neuroma
• Renal aneurysm coiling
• Renal denervation (RDN)
• Sclerotherapy, embolisation, or clipping for pelvic vein incompetence or pelvic venous congestion syndrome

Neurosurgery

• Embolisation or surgery for cerebrovascular abnormality (including aneurysm)
• Occipital neurectomy and denervation skull base

Oncology

• BioZorb breast implant
• Intraoperative radiation therapy (IORT)
• Irreversible electroporation (e.g. NanoKnife)
• Radioligand therapy
• Proton beam therapy
• Rectal spacer (e.g. SpaceOAR Hydrogel)
• Selective internal radiation therapy (SIRT)

• Transarterial chemoembolisation (TACE) or Drug-eluting bead transarterial chemoembolisation (DEB-TACE)

Ophthalmology

• BlephEx treatment
• Ellex 2RT ophthalmic laser (other than for the treatment of significant macular oedema)
• Eyelid warming (e.g. Blephasteam, EyeGiene, MGDRx eye bag, LipiFlow)
• Insertion of implantable telescope (e.g. CentraSight)
• Intense pulsed light (IPL) therapy for dry eye treatment
• Microstents and microshunts for the treatment of glaucoma / Minimally invasive glaucoma surgery (MIGS) (except for devices specified on the list of prosthesis and specialised equipment)
• Neural vision correction technology (e.g. NeuroVision therapy)
• Ophthalmology custom implants except when used for prosthetic iris device and Artificial eye implant
• YAG laser vitreolysis for vitreous floaters

Oral surgery

• Partial glossectomy using laser

Orthopaedic surgery

• Chitosan-based biomaterial (e.g. BST-CarGel)
• Collagen nerve wrap/conduit (e.g. Neuragen nerve guide)
• Interspinous dynamic stabilisation (e.g. Coflex, DIAM, Wallis, X-STOP)
• Lumbar/thoracic disc replacement
• Osteochondral grafting (e.g. OATS procedure, Mosaicplasty)
• Robotic orthopaedic surgery (except for Robot-assisted total hip replacement and Robot-assisted knee replacement)
• Sinus tarsi spacer for posterior tibialis reconstruction surgery
• Spinal cord stimulation (SCS) including dorsal root ganglion (DRG) stimulation
• Subtalar implants (e.g. ProStop, BIOARCH)
• Thermosensitive hydrogel (e.g. JointRep)

Plastic surgery

• Abdominoplasty and/or repair of rectus divarication
• Apronectomy/panniculectomy
• Brow lift, except as part of a major facial lesion removal
• Liposuction (except when used for an eligible breast reconstruction or revision surgery and secondary lymphedema following an oncological intervention)
• Secondary lymphoedema reconstruction

Skin

• Intralesional cryotherapy
• Laser treatment of skin lesions/conditions
• Microwave therapy for the treatment of axillary hyperhidrosis (e.g. miraDry)
• Photodynamic therapy (PDT)
• Phototesting for light sensitive dermatological disorders

Tests

• Cxbladder test
• Endocrine stimulation testing
• Gastric alimetry
• Hepatic venous pressure gradient test (HVPG)
• InflammaDry MMP
• Liquid biopsy (e.g. Guardant360, FoundationACT)
• Prenatal tests (except for amniocentesis, maternal serum screening, triple X test and chorionic villus sampling)
• Saline suppression test / Saline infusion test
• Tilt table test

Urology

• Allium prostatic stent
• Drug Coated Urological Balloon e.g Optilume 
• Percutaneous tibial nerve stimulation (PTNS)
• Periurethral bulking agent for urinary incontinence (e.g. Macroplastique) (except for Bulkamid)
• Prostatic urethral lift surgery (e.g. UroLift)
• Renal dialysis
• Resonance metallic ureteral stent
• Water vapour therapy for benign prostatic enlargement (e.g. Rezum)

Vascular

• Covered endovascular reconstruction of aortic bifurcation (CERAB)
• Fenestrated endovascular aneurysm repair (FEVAR)

Other

• Acellular dermal matrix / Biological mesh (except when used in breast reconstruction, rotator cuff repair, gastrointestinal surgery, gynaecological surgery, and head and neck surgery)
• Blood injections/transfusions/infusions (except when used for chemotherapy treatment)
• Botulinum toxin injections (e.g. Botox, Dysport) (except when used in the treatment of anal fissures and laryngeal dystonia, or into the bladder, urethra, or pelvic floor in conjunction with a pudendal nerve block)
• Colonic irrigation
• Custom implants including patient-specific and 3D printed except when used Orthopaedic, Cranial and Maxillofacial surgery
• Deoxycholic acid injection (e.g. Belkyra, Kybella)
• ExAblate system
• Extracorporeal shock wave therapy (other than for lithotripsy for the treatment of kidney stones)
• Fat grafting and fat grafts (except when used for an eligible breast reconstruction or revision surgery, or as part of eligible ENT, oral, orthopaedic and neurosurgical procedures)
• Feeding therapy
• Hilotherapy
• Hyperbaric oxygen therapy
• Laser treatment of ingrown toenails
• Laser haemorrhoidoplasty +/- mucopexy
• Limb lengthening using a Precice magnetic IM lengthening
• Oolo-Austin Trigenics (OAT) procedure
• Platelet-rich plasma (PRP) injections
• Radiofrequency neurotomy (except for thermal radiofrequency neurotomy of the medial branch nerves of the spine)
• Radiotherapy treatment for the benign conditions plantar fasciitis, heterotopic ossification, pigmented villonodular synovitis (PVNS), keloid scars and Dupuytren's contracture
• Stem cell therapy 
• Therapeutic phlebotomy / Therapeutic venesection
• Transilluminated powered phlebectomy
• Viscosupplementation / Hyaluronic acid injection (e.g. Intra-articular injection of Durolane, Synvisc, Sodium hyaluronate)