Chamber and committees

The Transvaginal Mesh Removal (Cost Reimbursement) (Scotland) Act 2022 (the 2022 Act) came fully into force on 3 May 2022. The 2022 Act gives powers to Scottish Ministers to make a scheme to reimburse women for the costs incurred in connection with qualifying mesh removal surgery.

The Transvaginal Mesh Removal Reimbursement Scheme 2022 has now been laid before Parliament – laying number SG/2022/87. The scheme will open for applications on 6 June 2022 and will remain open for a period of 18 months.

Reimbursement will mean that those women who previously felt they had no other option but to have mesh removal surgery out with NHS Scotland will no longer be at a financial disadvantage because of that choice. Women will be able to apply for reimbursement of the costs of surgery, and associated expenses, for themselves and one person who travelled with them. It should be noted that anyone who is eligible to apply and has previously made a successful application to the Mesh Fund will not be excluded from applying for reimbursement and any previous payment from the Mesh Fund will not be deducted. The Mesh Fund will close to new applications on 31 May 2022.

NHS National Services Scotland (NSS) are the administrators of the Scheme and application forms and further information on how to apply will be available on the mesh pages of their website Mesh Scheme | National Services Scotland (nhs.scot) .

The cut-off date, by which surgery has to have been arranged in order to be eligible for reimbursement, is specified in the Scheme and has been set at 3 June 2022. This will ensure that any woman who has made their own arrangements for surgery on or before this date will not be penalised for doing so and gives those in the process of making arrangements time to finalise them before the scheme opens. Section 1(3)(c) of the 2022 Act provides that the cut-off date could not be before the date of Royal Assent, which was 3 March 2022.

To be clear, anyone who wishes to have mesh removal surgery outside of NHS Scotland after 3 June 2022 should seek to do so through the official referral process as they will not be reimbursed if they make their own arrangements after that date.

It is expected that anyone seeking mesh removal after this date discuss their case with local clinicians within their own Health Board. If considered appropriate at that stage, they would then be referred to the Complex Pelvic Mesh Removal Service in NHS Greater Glasgow and Clyde for consideration by a full multi-disciplinary team (MDT). If, after careful consideration by both the MDT and the patient, it is agreed that surgery is appropriate, the patient can choose to be treated by the service already available in NHS Scotland or to be referred to a specialist NHS centre in England or to an independent provider. Each of these options will be available free of charge. I would encourage anyone who wishes referral to one of these services to make their wishes known to their clinical team, if they have not already done so.