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 under-reported.
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 – with extensive stakeholder engagement and the development of a clinical decision support tool and [online platform](https://4skin-health.alderhey.nhs.uk/), about which Men’s Health Forum commented: _“A resource like this, which is balanced is a great idea. Desperately needed.”_
Since beginning this work, phimosis diagnoses have reduced by a third (33.2%, 1,459 case reduction from 2019-2022) in children aged 1-15 years; and circumcisions in children 1-15 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 have produced a sensitive, informed and meaningful campaign that has exceeded its set goal. The situational analysis was well articulated, the objectives and strategy clear, and the execution flawless, underpinned by a fantastic ability to navigate all the dimensions that make our healthcare system work. This campaign set out to solve a problem in an extremely challenging area and has created an impressive impact.
