Health body to impose restrictions on routine surgery for obese people and smokers

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Operations for smokers and obese people are to be delayed in parts of Yorkshire in a radical move imposed by health commissioners battling to save £8.4m.

Routine surgery funded by NHS Harrogate and Rural District Clinical Commissioning Group (CCG) will be delayed by six months for patients who smoke or those with a Body Mass Index (BMI) of 30 or more.

During that time they will be offered help to improve their health in a move NHS executives say will “encourage patients to take a greater responsibility for their lifestyle choices”.

The controversial restrictions are the latest to be considered, after a similar proposal by the Vale of York was put on hold last month. Similar measures were discussed by Scarborough and Ryedale CCG last week, but a final decision has yet to be taken.

The governing body of NHS Harrogate and Rural District CCG yesterday agreed patients who smoke or those with a BMI of 30 will be offered six-month period of “health optimisation” before being referred for a non-urgent operation.

During that time they will be offered a referral to a weight management programme or stop smoking services.

The rule would not apply to some patients, including those needing surgery for cancer or suspected cancer, those having diagnostic procedures, children, frail elderly people, those with severe mental illness or a learning disability.

The CCG’s chief officer Amanda Bloor said: “I feel the measures we are taking encourage patients to take a greater responsibility for their lifestyle choices.

“The CCG is not saying patients can’t have the surgery. By introducing a six-month health optimisation period, we are encouraging and supporting patients to undertake a lifestyle change which will provide them with the best possible clinical outcome.

“With spending on obesity related ill-health and smoking related illness increasing year on year, these measures will help protect the future finances of the CCG and the wider local health economy.”

The CCG has a plan in place to save £8.4m but rising demand and increasing costs have seen the organisation’s budget stretched.

Other measures agreed were to reduce unnecessary hospital visits by reviewing follow-up appointments and working with GPs and pharmacies to cut spending on prescribed medicines.

Dr Lincoln Sargeant, director of public health for North Yorkshire, said: “We know that lifestyle changes such as stopping smoking and weight loss in obese patients can greatly improve their surgical outcomes and their general health and wellbeing.

“I support the Harrogate and Rural District CCG in their leadership on this important issue of prevention and will work in partnership to ensure patients can reduce surgical risk and have the best outcomes possible.”

Last month, the Vale of York CCG agreed to delay non-life threatening surgery by a year for smokers or those with a BMI exceeding 30. However NHS England intervened, which it was able to do as the CCG is in special measures. Work is now underway to “develop a policy that is clinically appropriate and proportionate”, according to the CCG.

Scarborough and Ryedale CCG last week considered restricting access to non-urgent operations but its governing body decided further discussions with GPs were needed.

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