Severely obese patients must put forward their own case for weight-loss surgery in the latest round of NHS cuts in the UK.
Panels of NHS officials will have to approve individual patients case by case as the health service faces increasing pressure to save money.
The move comes despite guidance from the National Institute for Health and Care Excellence (NICE), which says that weight-loss surgery should be extended to avoid diabetes, high blood pressure and heart attacks. Local areas took over responsibility for weight-loss surgery from NHS England this year and several have decided it should not be routinely available, saying that patients must make individual requests for funding.
Neil Mortensen, vice president of the Royal College of Surgeons, called on officials to “urgently” reconsider. “It is very disappointing to learn that clinical commissioning groups in Yorkshire will no longer be routinely funding bariatric surgery”, he said. “It singles out a particularly vulnerable group of patients, while simultaneously going against national guidelines on how to treat them.
“Patients will now be forced to wait while their clinician applies for permission and funding for them to undergo surgery. Delaying access to surgery like this will adversely affect their quality of life, and cost the NHS more money as they fund treatment for the long-term conditions associated with obesity.”
The Vale of York Clinical Commissioning Group (CGC) say that all such surgery must be approved by an individual funding request panel, more usually used in exceptional circumstances for treatments considered to be poor value.
A spokesman said that this “ensures that bariatric surgery is funded in a cost effective, fair and consistent way for those who are most likely to benefit.” He added: “Bariatric surgery is extreme surgery and the CCG needs to ensure that all conservative available options have been considered prior to surgery.” Harrogate and Milton Keynes are also considering similar approaches. The Vale of York was already one of several areas restricting operations to the “super-obese” with a body mass index above 50. National guidelines say patients can be considered for surgery if they have a BMI of 40 or more, or 35 or more if they have co-existing illnesses.
Fewer than 7,000 patients have weight-loss surgery on the NHS each year, but NICE predicts more than a million could benefit. They say that the £6,000 operations pay for themselves within two years by avoiding complications.
Feature courtesy of Chris Smyth (Health Editor) The Times