Winner
Improving Choice in the Treatment of Foreskin Conditions
Summary of work
Through his research with Getting it Right First Time (GIRFT), Professor Simon Kenny found that too many circumcisions are performed in the treatment of foreskin conditions, with geographical variation in the procedure’s use. While circumcision is considered safe, with few side effects reported, it is not always medically necessary – particularly for treating phimosis (non-retractable foreskin), which is thought to be over-diagnosed – there are alternative, less invasive treatments available and there is clinical concern that the psychological impacts of circumcision in non-infant children and adolescents are underreported.
In order to reduce unnecessary circumcisions, we sought to understand barriers to informed choice, deliver a clinical consensus, and policy, communications and educational solutions to overcome these barriers – including the development of an [online platform](https://4skin-health.alderhey.nhs.uk/) and [clinical decision support tool](https://4skin-health.alderhey.nhs.uk/healthcare-professionals/), about which one consultant commented:
“As I use it in clinic for about the 10th time today – I just wanted to say 4skin-health.alderhey.nhs.uk is absolutely fantastic and may possibly the be the best innovation in paediatric surgery. Ever.”
Since beginning this work, the number of circumcisions in children aged one to 15 years decreased by 20%, from 7,250 in 2019 to 5,799 in 2022, saving the NHS an estimated £1.5 million.
Judges’ comments
Evoke Incisive Health and Alder Hey completely smashed this project! It had strong benchmarking, addressed an unmet need with very clear objectives. The outcomes were fantistic both in terms of patient benefit and money saved. It was impactful, had clear measurements and strong collaboration. The judges were impressed with this impressive, strong and credible entry.
