Varicose Veins on the NHS in Nottinghamshire: Who Qualifies, and What to Do If You Don't

Most people who ask us about varicose veins have already asked their GP, and been told the NHS won’t treat them. In Nottinghamshire that is usually the correct answer, but it is rarely explained. The reasons are worth knowing, because the rule that ruled you out also tells you whether your veins need attention.

This guide sets out the local NHS rules as the Nottingham and Nottinghamshire Integrated Care Board publishes them, what happens if you meet them, and the options if you don’t. It covers Newark and the rest of Nottinghamshire. If your GP is in Lincoln, Grantham or Sleaford, they work to Lincolnshire’s rules, which we haven’t found published, so ask them which apply.

What the NHS in Nottinghamshire funds

Varicose veins are common. In the Edinburgh Vein Study, about a third of adults aged 18 to 64 had them. The NHS doesn’t treat most of them, and in Nottinghamshire the line is drawn in the ICB’s commissioning policy, the version on its website on 24th October 2026.

Referral to a hospital vein service may be funded if you have at least one of these:

• Varicose eczema. Itchy, scaly or discoloured skin over the veins, usually around the ankle.
• Lipodermatosclerosis or a varicose ulcer. Lipodermatosclerosis is skin on the lower leg that has become hard, tight and often brown.
• At least two documented episodes of superficial thrombophlebitis. That is a vein near the surface becoming hard, red and painful, and “documented” means each one is recorded in your medical notes.
• A major bleed from a varicose vein.

Even then, it needs prior approval: your GP applies and the ICB agrees before the referral goes ahead.

Does the NHS remove thread veins in Nottinghamshire?

Not routinely. The ICB’s policy describes thread veins as harmless and lists treatment to correct them as “not routinely commissioned”. Funding is possible only through an individual funding request in exceptional circumstances, and the policy says approval would not normally be expected.

Why aching legs alone don’t qualify here

National guidance is wider than the local rule. NICE guideline CG168 tells GPs to refer people whose varicose veins cause “troublesome lower limb symptoms (typically pain, aching, discomfort, swelling, heaviness and itching)”. The national Evidence-Based Interventions guidance also lists “symptomatic primary or recurrent varicose veins” for routine referral.

Nottinghamshire’s policy labels its varicose vein entry as following that national guidance, but its list starts at skin changes, an ulcer, repeated clots or a bleed. Symptoms on their own aren’t among its criteria.

So you can have aching, heavy varicose veins that NICE would refer, and still fall short of the local rule. The policy’s stated review date was September 2026, and no newer version had been published when we checked, so the rules may change. Your GP will know the current position.

Signs that need help now, not a booked appointment

If a vein is bleeding heavily, call 999.

A leg ulcer, a vein that has turned hard, red and painful, or skin changes around the ankle need your GP, and soon. NICE says bleeding varicose veins should be referred to a vascular service immediately.

None of these is something to book privately, here or anywhere else. They are the cases the NHS pathway exists for.

If you meet the criteria

Your GP applies for approval and refers you to a hospital vascular service. NICE sets out what should happen there:

1. A duplex ultrasound scan to confirm the diagnosis and find where blood is flowing the wrong way.
2. Heat treatment from inside the vein (endothermal ablation, by laser or radiofrequency) as the first choice where the main vein is leaking.
3. Ultrasound-guided foam if heat treatment isn’t suitable, and surgery if neither is.

NICE also says compression stockings shouldn’t be offered as the treatment unless those options are unsuitable. They can ease symptoms, but they don’t fix the vein. And interventional treatment isn’t normally carried out during pregnancy.

If you don’t meet the criteria

What makes sense next depends on which veins you have.

Thread veins only. Fine red or purple veins that don’t bulge. More than 80% of adults in the Edinburgh study had some. They are harmless, and treating them is a choice about appearance. We offer leg thread vein treatment with Dr Shahe Boghossian, starting with a £50 consultation, from £200 per area. The £50 comes off the cost if you go ahead.

Varicose veins without the skin changes. If they ache or swell, a private vascular service can scan them and offer heat treatment, the same first choice the NHS would use. Ask for the scan, the treatment and any follow-up to be priced separately and in writing, so two quotes can be compared. We don’t scan or treat varicose veins at this clinic.

Thread veins with varicose veins underneath. These need the deeper problem dealing with first. The Edinburgh study’s thread vein analysis found that about half of people with marked thread veins had no varicose veins, but almost everyone with marked varicose veins also had thread veins. Treating the surface while the vein underneath still leaks gives a result that doesn’t last.

What a consultation here can and can’t do

Our varicose vein consultation is with Dr Shahe Boghossian, Medical Consultant, GMC 5204600, who has a background in vascular surgery. You can check his registration on the GMC register. He asks about your symptoms and your health, examines your legs, and tells you what he finds.

He will also tell you whether you appear to meet Nottinghamshire’s NHS criteria. If you do, see your GP: there is no reason to pay for treatment the NHS should fund. If you need a scan or treatment, he refers you on. If you only have thread veins, he explains whether treatment here suits you.

It takes about 20 minutes and costs £50. Prices include VAT. The clinic is at 65 London Road, Newark-on-Trent, NG24 1RZ, with free parking at the front, and patients come to us from Balderton, Farndon, Collingham, Southwell, Bingham and Ollerton, and from Lincoln, Grantham and Sleaford. The leg vein concern page sets out every option we offer for veins.

Frequently asked questions