The National Health Service (NHS) took the decision not to offer circumcision for religious, cultural, social or personal reasons – also known as non-therapeutic – in 1949, very soon after its inception. This is because circumcision is not a medical necessity. Their decision led to a decline in the number of individuals undergoing circumcision in the United Kingdom.
A number of NHS hospitals later offered local non-therapeutic circumcision services, particularly during the 1980s and through some later local schemes. These were local exceptions rather than a nationally available NHS service.
International research has influenced public-health policy on circumcision. The World Health Organization supports voluntary medical male circumcision as one part of combination HIV-prevention programmes in countries with generalised HIV epidemics. Circumcision provides partial protection and does not replace condoms, HIV testing, PrEP, treatment or other established prevention methods. These international programmes do not change the ordinary NHS funding position in the United Kingdom.
Non-therapeutic circumcision on the NHS
Circumcision is common among certain religious groups, including Muslims and Jews, and within a range of cultural traditions. The NHS generally funds circumcision for specific medical reasons, so most non-therapeutic circumcisions are arranged privately. Local NHS bodies have occasionally commissioned particular services for their communities. The following are historical examples rather than a list of services currently available:
- Tower Hamlets: an NHS male circumcision service was established for Muslim families in 2007. It offered a charged service for boys under five months old. The local service ended in 2016.
- Sheffield: after ending free non-therapeutic circumcision in 2013, Sheffield Children’s Hospital offered a paid service for children aged six months and above. The price recorded at the time was £850.
These historic services no longer operate. As far as we are aware, there are currently no equivalent NHS services in England providing non-therapeutic circumcision. Families in England seeking circumcision for religious, cultural or personal reasons will therefore generally need to arrange it privately.
Patients may sometimes be considered through an Individual Funding Request where a GP or consultant believes there are exceptional clinical circumstances. Clinical Commissioning Groups were replaced by Integrated Care Boards in 2022. Current local arrangements can be discussed with a GP or the relevant Integrated Care Board.
Therapeutic circumcision on the NHS
The NHS provides circumcision free of charge when a urologist decides there is a medical reason for the procedure. The most common reasons are:
- Phimosis
- Paraphimosis
- Recurrent balanitis
- Balanitis xerotica obliterans
To seek circumcision for a medical reason through the NHS, speak to your GP. The GP can arrange a referral to a hospital urology or paediatric urology service. The specialist will assess you or your child and decide whether an alternative treatment may be appropriate before recommending circumcision.
If circumcision is offered, the hospital will explain how the procedure will be arranged. Waiting times vary between areas and according to clinical urgency, so current information should be obtained from the treating NHS service.
Situations where an operation can be arranged quickly include:
- Where there is a suspicion of cancer, a two-week-wait referral may be arranged by your GP.
- Paraphimosis can be a medical emergency. Paraphimosis is when the foreskin is retracted and cannot be replaced. This results in swelling and colour change of the tip, pain in the penis and may also result in the inability to pass urine. This condition requires immediate attention.
Health Insurance
Some private health-insurance policies cover circumcision when it is medically indicated. Circumcision chosen solely for religious, cultural or personal reasons is not normally covered.
A GP or consultant referral and prior authorisation from the insurer may be required. Cover, approved consultants and hospitals, excesses and follow-up arrangements vary between policies. Patients should confirm the current requirements with their insurer before arranging treatment or incurring costs.
Private non-therapeutic circumcision and the IMC
Individuals arranging non-therapeutic circumcision privately should choose an appropriately qualified and regulated provider. It is reasonable to ask about the practitioner’s experience, the methods offered, consent, infection control, aftercare and how concerns or complications are handled.
IMC provides circumcision for personal and religious reasons only. We do not provide diagnostic assessment or circumcision as treatment for a medical condition.
If you or your child requires assessment or circumcision for a medical reason, please speak to your GP or an appropriate urology service.