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Tonsillectomy

Please click here to view the full Tonsillectomy Commissioning Statement.  

Please click here to access the referral form.

Exclusions to policy

NHS Scarborough & Ryedale and Vale of York CCGs routinely commission treatment for Red Flag conditions (see clinical management). Please note this guidance only relates to patients with recurrent tonsillitis. It does not apply to other conditions where tonsillectomy should continue to be normally funded, these include :

Commissioning position

Referral criteria for possible tonsillectomy

The CCGs do not routinely commission tonsillectomy. Tonsillectomy will only be commissioned in accordance with the criteria specified below for recurrent acute sore throat in adults and children in the following circumstances:

Sore throats are due to acute tonsillitis where

AND THERE HAS BEEN

The impact of recurrent tonsillitis on a patient’s quality of life must be taken into consideration. A fixed number of episodes, as described above, may not be appropriate for adults with severe symptoms and an application can be made to IFR for earlier surgery.

Tonsillectomy for the treatment of halitosis associated with tonsillar debris is NOT routinely commissioned. The CCGs will also consider funding via IFR in children (aged <16) with sleep disordered breathing if ANY ONE of the following applies: 

Within secondary care, there should be:

Patients who are not eligible for treatment under this policy can be considered on an individual basis, where their GP or consultant believes exceptional circumstances exist that warrant deviation from this policy.

Individual cases will be considered by the Individual Funding Request panel.

Red flag conditions – consider need for admission or urgent referral

Acute Management of Sore Throats

NICE CKS states:

FeverPAIN score

The FeverPAIN clinical score can help prescribers to determine if a sore throat is more likely to be caused by bacteria. Higher scores suggest more severe symptoms and likely bacterial (streptococcal) cause. Each of the FeverPAIN criteria (below) score 1 point (maximum score of 5).

A score of 2 or 3 is associated with a 34% to 40% likelihood of isolating streptococcus. A score of 4 or 5 is associated with a 62% to 65% likelihood of isolating streptococcus

Centor criteria

Each of the Centor criteria score 1 point (maximum score of 4). A score of 0, 1 or 2 is thought to be associated with a 3 to 17% likelihood of isolating streptococcus. A score of 3 or 4 is thought to be associated with a 32 to 56% likelihood of isolating streptococcus.

Patient Information Leaflets

Adult Tonsil Surgery

Childrens Tonsil Surgery

Tonsillitis