Hallux valgus (bunion)

This clinical referral guideline has been developed to support the hallux valgus (bunion) commissioning policiy

Please note referral criteria are applicable.


Referral Criteria

Surgery for hallux valgus (bunion) for cosmetic purposes will not be routinely commissioned.. Referrals may be returned if the referral letter does not provide sufficient information to demonstrate the following criteria are met:

Failure of conservative methods of management after three months.

Conservative management techniques including:

  • Avoiding high heel shoes and wearing wide fitting leather shoes which stretch

Plus at least one of the following:

  • Exercises specifically designed to alleviate the effects of a bunion and keep it flexible
  • Non-surgical treatments such as bunion pads or orthoses.
  • Appropriate analgesia


the patient suffers from either:

  • Severe deformity (overriding toes) that causes significant functional impairment


  • Severe deformity that prevents patients from finding comfortable footwear


  • Severe pain that causes significant functional impairment. This includes persistent pain not relieved by short courses of simple analgesia. Referring GPs may be asked to provide evidence of analgesia or reasons why this approach is not appropriate.
  • Significant functional impairment is defined as:
  • Symptoms that prevent the patient properly fulfilling their required work or educational responsibilities
  • Symptoms that prevent the patient properly carrying out their required domestic or carer activities
  • Symptoms that prevent the patient carrying out recreational physical activities

Complete NEW Devon CCG hallux valgus (bunion) commissioning policy

Where the circumstances of treatment for an individual patient do not meet the criteria described above exceptional funding can be sought. Individual cases will be reviewed by the appropriate panel of the CCG upon receipt of a completed application from the patient's GP, consultant or clinician. Applications cannot be considered from patients personally.

Individual funding requests

Referral Form

Hallux Valgus (bunion) Interventions - emisweb

Hallux Valgus (bunion) Interventions - Microtest

Hallux Valgus (bunion) Interventions - No merge fields

Hallux Valgus (bunion) Interventions - Systmone

Supporting Information

Patient Information

MyHealth patient information - Bunions

Pathway Group

This guideline has been signed off on behalf of NEW Devon CCG by the Planned Care Control Centre.

Publication date: May 2017


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