By Zoe Fripp
Smokers and overweight patients will be banned from undergoing surgery by the NHS unless they can quit their habit or lose weight, in a new provision drawn up in Hertfordshire.
The restrictions mean that obese patients, who in the past would have faced delays, could be refused surgery entirely until they can lose weight. Patients with a BMI of 30 or more must lose at least 10% of their weight, and those with a BMI of over 40 must lose at least 15% before they are even considered for surgery. Additionally, smokers will be breathalysed to check the carbon monoxide levels in their body before being referred to a consultant or approved for surgery.
The faction responsible for the new rules, the East and North Hertfordshire Clinical Commissioning Group (CCG), was quoted by the Telegraph as saying:
“This policy is designed to improve patient safety and outcomes, both during and immediately after non-urgent surgery. No financial savings are expected as a result of these measures. We do however hope to improve the long-term health of our residents through the targeted stop-smoking and weight-loss support on offer to patients.”
The Hertfordshire Valley added that the plans aimed to encourage better responsibility for health and wellbeing, which they hope will “free up limited NHS resources for priority treatment.”
The ruling has caused great controversy, with the Royal College of Surgeons (RCS) instantly opposing it saying that it goes against all the fundamental principles of the NHS.
“This goes against clinical guidance and leaves patients waiting long periods of time in pain and discomfort. It can even lead to worse outcomes following surgery in some cases,” the senior vice president of RCS, Ian Eardley, said.
The West Hertfordshire Hospitals Trust medical director, Michael Van der Watt, also believes the terms of the ruling are not justifiable, as “there is a wealth of evidence that does not support the theory that worst outcomes occur in patients with a BMI greater than 30”.
The official ruling of the East and North Hertfordshire CCG, posted on the Healthier Future website, nonetheless states that the decision was made with the public’s opinion in mind. It said:
“During an extensive public engagement campaign – which included meetings, drop-in discussion events, press coverage and a social media campaign – thousands of online and postal responses were received from members of the public, special interest groups, clinicians, local well-being groups and providers of specialist fertility services.”
Dr. Nicholas Small, the chair of Hertfordshire Valleys CCG, responded to the opposition by saying they received “wide public backing”, and a spokesperson for Hertfordshire Valleys CCG said that patients that do not meet the non-smoking requirements or fail to lose enough weight will be offered another attempt and given advice on the best way to move forward.
The ruling also involves a decrease in funding for IVF, meaning only one cycle will be funded for those that meet the criteria, rather than two, and accessibility to routine prescriptions of medicines will also be limited.
Local political parties have also weighed in, with the St Albans Green Party reportedly condemned these changes and suggesting that “those who can afford services will buy them and those who cannot will go without”.
To read the official decisions and find out how it was reached, you can visit the Healthier Future website.