NHS Commissioning and Access Policy

The clinical effectiveness of surgical correction for severe pectus excavatum is widely contested among clinicians, commissioners, and payers. NHS England decommissioned pectus excavatum surgery in 2019, citing the absence of high-quality comparative data demonstrating physical or cardiopulmonary benefit. Pectus excavatum surgery was reinstated in England but restricted to the most severe cases verified by a national multidisciplinary team. Patients who cannot safely wait 12 months for treatment, as determined by a national MDT, are enrolled in a parallel observational cohort rather than the RCT.