Children’s tonsil removal often unnecessary

With NHS England planning to cut back on tonsil removal surgery, a new study claims that seven in every eight children given tonsillectomies were unlikely to benefit from the operation.

A research team from the University of Birmingham said that thousands of children are having their tonsils removed unnecessarily, costing the NHS millions of pounds each year. Roughly 37,000 tonsillectomies were performed on children in England by the NHS between April 2016 and March 2017, carrying a bill of £42 million.

In fact, according to experts, few young people who had the procedure fitted any of the main criteria, which is documented as: more than seven documented sore throats in a year; more than five sore throats per year for two successive years; and three sore throats per year for three successive years. Furthermore, thousands of children who would have met the requirements to have their tonsils out have not had the operation.

The study examined the UK medical records of more than 1.6 million children between 2005 and 2016, during which time more than 18,000 children had their tonsils removed. However, only 2,144 (about 12 per cent) had had enough sore throats to justify surgery.

Almost one in 10 had suffered just one sore throat before being offered the surgery. Two or three children per 1,000 underwent tonsillectomy annually between 2005 and 2016 - but fewer than one in eight of them met the recommended criteria. Based on these findings, the researchers estimate that 32,500 of the 37,000 child tonsillectomies in 2016-2017 in the UK were unnecessary, costing the NHS £36.9 million.

Tom Marshall, professor of public health and primary care at the University of Birmingham, said: “If your child is very severely affected there is a modest benefit [to having the operation], but the bottom line is that even the most severely affected children don’t always have their tonsils out and they seem to grow out of [sore throats] – it doesn’t lead to any long-term problems.

“What emerges from what we found is most of the tonsillectomies that are being done in children at the moment, there isn’t really an evidence base that says they will [see a] benefit so … they are probably at risk of being harmed more than benefiting.”