Obese patients may face NHS surgery ban to save money
Obese patients could be refused surgery for up to a year as part of efforts to save money, an NHS commissioning group in North Yorkshire has said.
Officials at the Vale of York Clinical Commissioning Group said the decision came at a time when the local system was under “severe pressure”.
But NHS England said it was asking for the plans to be reviewed to make sure they were proportionate and reasonable.
It can intervene because the CCG is under special measures.
The move would see a ban on, for example, hip and knee operations, with the restrictions applying to patients with a body mass index of 30 or above which indicates obesity, as well as smokers.
If, however, the patient can shed 10% of their weight, they could be referred within the year.
The new rules would only apply to elective surgery for non-life threatening conditions.
‘No blanket bans’
But a spokesman for NHS England said: “Reducing obesity and cutting smoking not only benefits patients, but saves the NHS and taxpayers millions of pounds.
“This does not and cannot mean blanket bans on particular patients such as smokers getting operations, which would be inconsistent with the NHS constitution.
“Vale of York CCG is currently 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.”
Chris Hopson, the head of NHS Providers representing acute care, ambulance and community services, said it was a real worry that a number of decisions like this had been made.
NHS bosses now believed they had reached the point at which the health service was simply being asked to deliver too much for the funding that was available, he told BBC Radio 4’s Today programme.
He said rather than commissioning groups making “piecemeal decisions”, there should be a national debate about the future of the healthcare system.
Shaw Somers, a bariatric surgeon based in Portsmouth, said it was a fairly logical step to save money, but was short-term and discriminatory.
“Obesity is an illness and for these people, they are not deliberately waking up each morning thinking ‘how do I stay fat?’,” he told the Today programme.
“They are trying to lose weight in the vast majority of cases and to deny them treatment that they need on the basis of their weight, without then offering them effective help to help them lose weight is rather like discriminating [against] a segment of the population on the basis of their colour or religious persuasion.”
Body Mass Index
- Body mass index (BMI) is used to calculate whether a person is underweight, a healthy weight, overweight or obese for their height
- It is calculated by dividing someone’s weight in kilograms by the square of their height in metres
- Generally the higher your BMI, the greater your risk of a large range of medical problems
- A BMI above 30 is medically classified as obese
The Royal College of Surgeons (RCS) described the restrictions as “some of the most severe the modern NHS has ever seen”.
Clare Marx, RCS president, said: “Smokers and overweight patients should unquestionably be helped to stop smoking or lose weight prior to surgery for their overall health.
“We would support any attempts by Vale of York to expand its weight loss and smoking cessation programmes, but introducing blanket bans that delay patients’ access to what can be life-changing surgery for up to a year is wrong.”
A major study of the global obesity problem by Imperial College scientists found there were 6.8 million obese men in the UK in 2014, and 7.7 million obese women.
Former health minister Norman Lamb said: “This is just the latest in a growing list of local decisions to ration care – any rationing not based on clinical need is outrageous.”
A statement from the Vale of York Clinical Commissioning Group said: “The local system is under severe pressure.
“This work will help to ensure that we get the very best value from the NHS and not exceed our resources or risk the ability of the NHS being there when people really need it.”
It said the group wanted to support work to help people in the community to stop smoking and, where needed, lose weight.
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