East and North Hertfordshire CCG requires a patient’s BMI to be under 30 before surgery – or for them to lose 10 per cent of body weight if this is unachievable.
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The decision by the Vale of York clinical commissioning group to restrict access to cataract, hip and knee surgery for obese people has been described by the Royal College of Surgeons as…
NHS Providers, which represents NHS leaders, said similar decisions like this were likely to follow in future.
The Royal College of Surgeons dubbed the decision “the most severe the modern NHS has ever seen”.
The CCG initially said that the plans were necessary because of “severe pressure” on its health services.
‘This does not and can not mean blanket bans on particular patients such as smokers getting operations, which would be inconsistent with the NHS constitution. An investigation carried out by GP magazine in March 2015 found that 83% of CCGs had denied patients treatment for infertility, joint replacements and aesthetic surgery as their BMI was considered too high. “Reducing obesity and cutting smoking not only benefits patients but saves the NHS and taxpayers millions of pounds”, they added.
Controversial plans drawn up by the Vale of York CCG to restrict non-emergency surgery for patients who are obese or smokers have been put on hold.
BMI uses a calculation based on height and weight to work out whether someone is in the normal weight range.
“Vale of York CCG is now under “special measures” legal direction, and NHS England is today asking it to review its proposed approach before it takes effect to ensure it is proportionate, clinically reasonable, and consistent with applicable national clinical guidelines”. A score over 25 is overweight, while over 30 is considered obese. “There’s no doubt the population is getting older and getting fatter and it’s an outrage that the local NHS is not shouting from the rooftops that people need to look after themselves”.
Marx said: “Smokers and overweight patients should unquestionably be helped to stop smoking or lose weight prior to surgery for their overall health”.
‘At this rate we may see brutal service reductions becoming the norm, rather than just being exceptions’.
But Dr Nina Pearson, clinical chairman of Luton CCG, said: ‘Our policies are there to help us provide people with relevant evidence-based support to achieve the best outcomes and, where possible, to encourage people to do as much as they can to manage their own health.
“It’s the only way providers are going to be able to balance their books, and in a way you have to applaud their honesty”.
Cancer patients and those with conditions which could become life-threatening will not be included, and surgery will not be postponed if exceptional circumstances can be shown.
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“Tackling common risk factors for numerous preventable diseases affecting people in the Vale of York such as improving the appropriate use of health and care services and ensuring patients gain the most benefit from the interventions they receive is a strategic priority”.
