On Sunday 14 April 2023, the UK government published an update to their recommendations for Dupuytren’s Disease as industrial disease.
Previously the point at which a claim could be made by someone who had worked with heavy vibrating tools for 10 years or more (at least 2 hours a day for 3 or more days per week) was when they failed Hueston’s ‘Table top test’.
It has now been decided that that could give rise to claims where the patient does not have a significant disability yet. The government therefore changed the rules, and now there has to be a 45 degree contracture at the MCP or any PIP contracture.
This means only of the condition gets bad enough that surgery is warranted can a person claim. Our concern is, that the best results from surgical treatment are achieved at 30-45 degrees MCP contracture, and if a patient has needle release treatment (PNF), that tends to be done sooner even. So now patients would have to wait getting treatment untill a 45 degree contracture can be recorded.
We can foresee a problem arising for patients who have to wait until they reach the 45 degree stage before the disease can be documented for a claim, and only go on the waiting list for surgery afterwards. The chance to have successful PNF will be less and most surgeons will advise fasciectomy directly. Tissues will be quite contracted, and depending on the wait for surgery a skingraft may well be needed.
Whereas we can understand the rationale of only considering a claim if the condition causes problems in the use of the hand, we fear that setting the level at 45 degrees there will be people who either can not claim as they have treatment before they reach that stage, or who have to wait until the optimal timing for surgery has passed.
We would have far preferred if the government had set a starting point for claims at 25-30 degrees MCP contracture, or said “pain or any functional deficit”.
In order to show the government how patients feel about this, we have started a petition on change.org: https://chng.it/LJqmQpRKqD
Press Release from the British Dupuytren’s Society.