Please see below for the policies relating to urinary tracts. To view the policy, patient leaflet and additional information, please click on the relevant heading.

What is male circumcision?

Male circumcision is an operation to remove the skin at the top of the penis (foreskin). It is mostly done in babies and young children but can be done at any age.

It is an effective procedure and can give benefit for a range of medical conditions. Sometimes it is requested on cultural, social and religious reasons and is a common practice in the Jewish and Islamic faiths, and is also practiced by many African communities as a tribal or ethnic tradition. Note: female circumcision (FGM) has no medical benefits and is illegal under the Female Genital Mutilation Act (2003).

Patient eligibility criteria:

The patient's local NHS commissioning organisation will fund male circumcision if the patient meets the following medical circumstances:

  • Where the foreskin gets trapped under the tip of the penis (pathological phimosis)
  • Three documented episodes of inflammation of the head of the penis (balanoposthitis). This can lead to a condition where the foreskin is too tight to be pulled back over the head of the penis (glans)
  • Related indications for circumcision or other foreskin surgery include the following:
    • Prevent infection of the body's drainage system for removing urine or pee (urinary tract) in patients with an abnormal urinary tract
    • When the foreskin can no longer be pulled over the tip of the penis (recurrent paraphimosis)
    • Trauma (e.g. zipper injury)
    • Tight foreskin causing pain on arousal/interfering with sexual function
    • Abnormalities from birth.

The clinician in charge of the care of the patient’s specific condition, usually a hospital doctor, can assist the application, if there is exceptional clinical need for the treatment to be funded. The patient’s clinician must evidence clinical exceptionality and must be supported by the patient’s local NHS commissioning organisation. See separate leaflet for more information on Individual Funding Requests (IFRs).

Advice and further guidance:

The patient will usually either have a general anaesthetic, which means the patient will be unconscious throughout the procedure, or a local anaesthetic injection, which will numb the penis and the surrounding area. In some cases, a spinal anaesthetic is used, where the patient will be unable to feel anything below the waist.

For more information search for ‘circumcision’ on the NHS UK website. 

Male circumcision for cultural, social and religious reasons

NHS Birmingham Solihull CCG does not commission male circumcision for cultural, social and religious reasons. See separate leaflet Circumcision services for baby boys in Birmingham and Solihull leaflet for more information. This leaflet is also available in the following alternative languages:

Advice and further guidance

  • For more information, search for ‘circumcision’ at www.nhs.uk
  • Choosing Wisely UK is part of a global initiative aimed at improving conversations between patients and their doctors and nurses.

This guidance is produced by The Academy of Medical Royal Colleges (the Academy) as part of the Evidence-based interventions programme. It is based on recommendations from the Expert Advisory Committee and the National Institute for Health and Care Excellence (NICE).

All guidance has been reviewed by the Birmingham and Solihull & Sandwell and West Birmingham CCGs’ Treatment Policy Clinical Development Groups (TPCDG). This was reviewed to establish if existing CCG policies were already in place which covered the proposed intervention / treatment in question.

Where there was no current CCG policy for the area in question, the NHSEI policy has been implemented in full into the CCG’s Clinical Treatment Policy portfolio.

Where there was a current CCG policy for the area in question, then the existing CCG policy has been reviewed by the TPCDG considering the NHSEI EBI policy rationale and evidence base.  A decision has then been taken by TPCDG based on the review as to the most appropriate policy for implementation by taking into account the healthcare needs of our local population.

The aims of the Evidence Based Interventions programme is to ensure the quality and safety of patient care by, freeing up valuable resources such as time so that more effective interventions can be carried out, reducing harm or the risk of harm to patients, helping clinicians maintain professional practice, creating headroom for innovation, and maximising value and avoiding waste.

This guidance is produced by The Academy of Medical Royal Colleges (the Academy) as part of the Evidence-based interventions programme. It is based on recommendations from the Expert Advisory Committee and the National Institute for Health and Care Excellence (NICE).

All guidance has been reviewed by the Birmingham and Solihull & Sandwell and West Birmingham CCGs’ Treatment Policy Clinical Development Groups (TPCDG). This was reviewed to establish if existing CCG policies were already in place which covered the proposed intervention / treatment in question.

Where there was no current CCG policy for the area in question, the NHSEI policy has been implemented in full into the CCG’s Clinical Treatment Policy portfolio.

Where there was a current CCG policy for the area in question, then the existing CCG policy has been reviewed by the TPCDG considering the NHSEI EBI policy rationale and evidence base.  A decision has then been taken by TPCDG based on the review as to the most appropriate policy for implementation by taking into account the healthcare needs of our local population.

The aims of the Evidence Based Interventions programme is to ensure the quality and safety of patient care by, freeing up valuable resources such as time so that more effective interventions can be carried out, reducing harm or the risk of harm to patients, helping clinicians maintain professional practice, creating headroom for innovation, and maximising value and avoiding waste.

This guidance is produced by The Academy of Medical Royal Colleges (the Academy) as part of the Evidence-based interventions programme. It is based on recommendations from the Expert Advisory Committee and the National Institute for Health and Care Excellence (NICE).

All guidance has been reviewed by the Birmingham and Solihull & Sandwell and West Birmingham CCGs’ Treatment Policy Clinical Development Groups (TPCDG). This was reviewed to establish if existing CCG policies were already in place which covered the proposed intervention / treatment in question.

Where there was no current CCG policy for the area in question, the NHSEI policy has been implemented in full into the CCG’s Clinical Treatment Policy portfolio.

Where there was a current CCG policy for the area in question, then the existing CCG policy has been reviewed by the TPCDG considering the NHSEI EBI policy rationale and evidence base.  A decision has then been taken by TPCDG based on the review as to the most appropriate policy for implementation by taking into account the healthcare needs of our local population.

The aims of the Evidence Based Interventions programme is to ensure the quality and safety of patient care by, freeing up valuable resources such as time so that more effective interventions can be carried out, reducing harm or the risk of harm to patients, helping clinicians maintain professional practice, creating headroom for innovation, and maximising value and avoiding waste.