Tonsillectomy for Sleep Disordered Breathing and Obstructive Sleep Apnoea (OSA) in Children <16 years

Threshold

Norfolk and Waveney Integrated Care Board (ICB) will fund treatment of OSAS in children if the following criteria can be met.

There is a strong history suggestive of obstructive sleep apnoea such as:

• witnessed obstructive apnoea
• difficulty breathing whilst asleep
• sleeping in an unusual position (with head extended)
• secondary enuresis
• frequent daytime mouth breathing
• behavioural or concentration problems
• with documented evidence of significant impact on quality of life (for example behavioural or concentration problems, failure to thrive, slowing of weight gain)

AND

• Clinical diagnosis of obstructive sleep apnoea by a designated ENT consultant with documented clinical features such as adenotonsillar hypertrophy and mouth breathing, with or without evidence of desaturation from a sleep study.

The clinic record should indicate the evidence that has been evaluated to indicate a significant impact on quality of life (e.g. GP letter, secondary care clinical examination by secondary care consultant, letter from school, sleep study results).

Tonsillectomy is not routinely funded for the treatment of sleep apnoea in adults.

Tonsillectomy will not be funded as a treatment for snoring

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.