CCGs must stop restricting weight loss surgery, BOMSS and RCS says

The British Obesity and Metabolic Surgery Society (BOMSS) and the Royal College of Surgeons (RCS) has called on NHS clinical commissioning groups (CCGs) to stop restricting weight loss surgery, after data has suggested many have introduced policies to ration such operations.

A freedom of information (FOI) request submitted to all NHS commissioning groups (CCGs) indicated that several CCGs have adopted policies which attempt to ration weight loss surgery to the super-obese, and ignore official advice on who should be eligible for surgery.

The National Institute for Health and Care Excellence (NICE) states that surgery is cost effective and should be considered for patients with a BMI of over 35 with a co-morbidity (a further medical condition i.e. Type II diabetes), or a BMI of 40 without a co-morbidity.

The responses revealed that six CCGs are not complying with the NHS England and NICE guidance. The policies put in place included directing that patients must have a BMI of at least 50 before being considered for surgery and restricting treatment to non-smokers at the time of referral before they can be considered.

Shaw Somers, Consultant surgeon and BOMSS President, said: “Our survey reveals worrying evidence that some CCGs are effectively taking the law into their own hands and defying official guidance on surgical interventions which have been proved to help people with a serious medical condition and also save healthcare costs.

“It typifies the second-class citizen manner in which bariatric patients seem to be viewed by some CCGs.

“We are calling on NHS England and NICE to make it clear to CCGs that they must comply with the guidelines on who is eligible for this safe and effective treatment, not try to ration it in a misguided attempt to save money in the short-term.”

Clare Marx, president of the Royal College of Surgeons, said: “Study after study shows bariatric surgery is highly effective, particularly in treating type 2 diabetes associated with obesity. It is therefore astounding that commissioning groups are effectively indicating that obese patients should get even more obese before they will consider surgery. This makes no sense and contradicts our very strong public health messages about the benefits of losing weight.

Marx added: “Bariatric surgery is a significant medical innovation which should be made available to those patients who meet criteria which NICE have considered and published.”