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Contradictory PIP breast implant guidance leaving GPs in ‘awkward position’

Conflicting Department of Health guidance over PIP breast implants is causing confusion among GPs and patients, an LMC leader has warned.

Advice to GPs in a letter from the Chief Medical Officer sent on 27 January states it is up to GPs to decide if they should refer asymptomatic patients who are worried about their implants for a scan or to a local breast reconstruction service.

It adds: ‘The criteria for replacement at NHS expense should be the same as for a request for primary breast augmentation.'

But a patient leaflet included with the guidance and published in the national press gives the impression that the decision can be made by the patient.

The leaflet says: ‘If you decide you want your implants replaced, the NHS will do it for free if your original operation was done on the NHS.'

In a recent case, a GP in the Wirral was faced with a patient who asked to have her implants removed on the NHS, even though there was no apparent clinical problem.

Her GP was left in a quandary because the patient leaflet had led the patient to believe it was her decision whether to have the implants removed.

Dr Andy Mimnagh, Sefton LMC chair, said: ‘The discrepancy does not seem to have been noted or addressed by the CMO, and may have been the direct cause of the patient consulting on this matter and dissatisfaction with the GP's reply.'

‘This is help we could do without. It´s putting GPs in an awkward position. It looks as if the DH stance changed and their guidance hasn´t caught up.'

A DH spokesperson said: ‘It´s up to the individual clinicians to decide - not the patient. If anxiety is affecting the patient´s mental health, they may decide the implants should be removed.'

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