NHS limiting surgery to smokers and obese

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Due to the cuts in budgets, the NHS has been forced to deny routine operations to patients who are morbidly obese and those who smoke.

The Western, Eastern and Northern Devon Clinical Commissioning Group said these are ‘urgent and necessary’ measures in a bid to help in the recovery of a £14.5m debt.

The new policy will state that morbidly obese patients have to lose a specified amount of weight prior to becoming eligible for any type of non-urgent surgical procedure. Patients who fall into this category have a body mass index of 40 or more, which is equal to a 6ft tall male weighting slightly over 20 stone. The CCG, which covers around 900000 people, has not yet made a decision on how much weight has to be lost, but it could be several stone to bring them into a category of ‘obese’ or ‘overweight’.

It is also demanding that smokers stop smoking for at least six weeks prior to being placed on the waiting list for all non-urgent surgical procedures.

Experts have issued accusations that managers are ‘prescriptively’ rationing treatment options because of the patient’s lifestyle.

The National Obesity Forum’s Tam Fry stated that operations such as knee and hip replacements would aid the obese and help them to exercise. According to Fry, this is a cost-cutting and prescriptive measure and this type of operation would be cost effective in the long term and help patients.

The organisation responded by stating that it had no choice and needed to make sure that there was sufficient funds to care for patients during the hectic winter months.

This is not the first time managers have had to resort to such arbitrary methods in a bid to cut costs.

During 2012, it was revealed that one quarter of the trusts were placing restrictions on at least one procedure from smokers and the obese. In most cases, this was IVF. Managers then stated that surgery may become riskier and could be less effective for patients who are severely overweight or those who smoke. They are at higher risk of developing complications due to the general anaesthetic, such as kidney failure, heart attacks, blood clots or pneumonia.

It was stated that knee and hip replacements are generally less successful in the obese and there was evidence that they did not benefit as much from IVF.

The CCG’s cost-cutting process is also making it more difficult for all patients to undergo cataract surgery or to have hernias removed.

The chief officer at the CCG, Rebecca Harriott, said their actions are a bid to protect essential services during their busiest winter months and to ensure that patients who really need it have access to care.

Image Credit: Artur Bergman

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