Patients are being denied access to bariatric surgery because intensive weight loss programmes, which are a prerequisite to surgery, are not being commissioned in some areas, the Royal College of Surgeons and the British Obesity and Metabolic Surgery Society has warned.
A lack of provision in some parts of the country is leaving obese patients unable to access the vital services they need to control their weight which could potentially put their health at risk. Last year, NHS England, which is responsible for commissioning bariatric surgery, published a clinical commissioning policy on the specialised management of severe and complex obesity.
The published policy reflects NICE guidance that recommends individuals have tried and exhausted all non-invasive treatment options prior to potentially higher-risk surgical approaches. As part of this, it requires patients to complete support from weight management services (called ‘tier 3’ support) which helps them to succeed in controlling their diet post-surgery.
Recent Hospital Episodes Statistics data shows there has been a fall of 10% in the number of bariatric surgical procedures being performed between April 2012 and March 2013, even though the most recently available statistics show obesity rates in England continue to rise. The RCS is concerned that the current problems with commissioning weight management has led to a further fall in the number of bariatric procedures, as these programmes are a prerequisite for referral to bariatric surgery.
Richard Welbourn, President of the British Obesity and Metabolic Surgery Society (BOMSS), said:
"It is concerning that patients are being denied access to treatment due to weight assessment and management clinics not being commissioned. The benefits of bariatric surgery are well-known. It leads to greater body weight loss and higher remission rates of type 2 diabetes than non-surgical treatment of obesity. Poor access to bariatric surgery therefore places some patients at continuing health risk. In the long run this will end up costing the NHS more."
