Dear Ms Viviani

Your application has now been fully assessed, and unfortunately cannot be approved.

As part of the assessment process, your application has to provide evidence to meet strict eligibility criteria and on this occasion, we do not have evidence to support the following:

Application Route:  Directive

Treatment: Surgery for a large sacral meningeal cyst involving two parts:

1.    Treatment of the large sacral meningeal cyst

2.    Dorsal sacral (tailbone) reconstruction

Reason for rejection: the treatment is not available under the NHS, either routinely or through specialised commissioning.

We therefore, unfortunately, have to reject your application, based on the information provided.

The options now available to you are:

1)    Accept this decision.

2)    Request a review of the decision, by providing further relevant information / evidence to support your application, in relation to the rejection decision.

3)    Appeal the decision by sending an email to: england.europeanhealthcare@nhs.net.

Please use reference: EU00461 in any future correspondence.

Kind regards

European Cross Border Healthcare Team (2)

NHS England

Fosse House | 6 Smith Way | Grove Park | Enderby | Leicestershire | LE19 1SX